PEDS: Chapt. 25,

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The infant measures 21.5 in. (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of 6 months?

27.5 in. (69.9 cm) Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old. By 12 months of age, the infant's length has increased by 50 percent. Pg 64

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. What action would have the most effect on the infant's neurologic development? a) Promoting continuation of breastfeeding b) Establishing an adequate level of dietary iron intake c) Requiring more solid foods in the diet d) Adding fruit juice daily

The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which findings are normal for this infant? Select all that apply. a) Blood pressure 100/50 b) Temperature 99 degrees Farenheit c) Respiratory rate 28/minute d) Respiratory rate 55/minute e) Heart rate 101 beats per minute

A, B, C, E

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: a) is a protective reflex and retained for life. b) should have disappeared. c) should be pronounced and easy to elicit. d) is expected to appear within 1 month.

The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed? a) Upper central gumline b) Lower central gumline c) Upper lateral gumline d) Lower lateral gumline

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention? a) Recommend the mother offer smaller and more frequent feedings. b) Observe the mother while she feeds and burps her infant. c) Describe the capacity of a 5-week-old infant's stomach. d) Offer assurance that spitting up is normal.

When assessing a 5-month-old infant, which symptom would the nurse bring to the health care providers attention?

Presence of Moro embrace reflex

In working with an infant, the nurse recognizes what as a characteristic of the infant?

The child grows and develops skills more rapidly than at any other time in their life. The infant grows and develops skills more rapidly than she ever will again. The toddler insists she can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours. Page 64

A 15-month-old boy has been brought to the clinic because he is pale and listless. Iron deficiency anemia is suspected. The nurse interviews the mother about the child's diet. Which of the following would the nurse identify as possible contributing factor?

The child drinks 4 cups of milk per day

In working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant.

The child grows and develops skills more rapidly than at any other time in their life Explanation: The infant grows and develops skills more rapidly than he or she ever will again. The toddler insists they can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours.

In working with an infant, the nurse recognizes what as a characteristic of the infant?

The child grows and develops skills more rapidly than at any other time in their life.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age. Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age. Explanation: Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age: Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age. Pg 64

The public health nurse is conducting a clinic to help identify those children who are most at risk of becoming obese due to poor nutrition. Which children does the nurse correctly identify as being at a high risk? Select all that apply.

The child whose guardians are elderly grandparents living in senior government housing The child whose father and mother earn minimum wage at their jobs and have 3 younger siblings The child with 2 younger siblings whose father is single and has been out of work for 6 month Certain health concerns, such as poor nutrition, obesity, infections, lead poisoning, and asthma, affect poor children at higher rates and with greater severity than affluent and middle-class children. The child with elderly grandparents living in government housing, parents working for minimum wage, and a father unemployed for 6 months pose a high risk of obesity due to the likelihood of poor nutrition from the financial situation. pg 14

A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him?

The child's gum line will be tender. Explanation: Normal teething creates tender gum lines but does not include an elevated temperature or constipation.

A father asks the nurse what symptoms he can expect with normal teething in his infant. What would the nurse tell him?

The child's gumline will be tender.

A father asks you what symptoms he can expect with normal teething in his infant. What would you tell him?

The child's gumline will be tender.

A father asks you what symptoms he can expect with normal teething in his infant. What would you tell him?

The child's gumline will be tender. Normal teething creates tender gumlines but does not include an elevated temperature or constipation.

During the weekly team meetings, the physician and case manager discuss the client's planned assent. What activity should the nurse most anticipate?

The client will have a conference with the physician about the planned course of care and treatment. Assent means agreeing to something. In pediatric health care, the term assent refers to the child's participation in the decision-making process about health care. As a child gets older assent or dissent should be given more serious consideration. The pediatric client needs to be empowered by physicians to the extent of his or her capabilities, and as the child matures and develops over time the client should become the primary decision maker regarding his or her health care.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?

The development of a 3-month-old Explanation: The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?

The development of a 3-month-old The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?

development of a 3-month-old: The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms. Pg 64

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

family. The family is the basic system in which health behavior and care are organized, secured, and performed. In most families, the parents or guardians, as advocates for their child, provide health promotion and health prevention care, as well as primary management of care when the child is sick. Parents and guardians have the prime responsibility for initiating and coordinating services rendered by health professionals.

The best way for an infant's father to help his child complete the developmental task of the first year is to:

respond to her consistently. A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client? -Newborn -Infant -Child -Baby

Newborn

The nurse is promoting a healthy diet to the mother of a 6-month-old. What action would have the most effect on the infant's neurologic development?

Promoting continuation of breast-feeding

Which milestone would you expect an infant to accomplish by 8 months of age?

Sitting without support Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.

The nurse is education the mother of a 6-month-old boy about the symptoms for teething. Which of the following symptoms would the nurse identify?

The child increases biting and sucking

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?

The development of a 3-month-old

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices. The leading cause of death throughout childhood is unintentional injury. pg 15

A home visit nurse is providing health promotion on safety to a family of a 1-week-old infant. Which of the following statements by the parents indicates the need for further teaching?

"We will position our infant on his side for sleeping."

"What does his stool look like?"

A 5-year-old child is brought to the emergency room with an open chin laceration following a bike accident. The child appears extremely frightened and asks if he will bleed to death. Which nursing action should the nurse prioritize to best assist this child?

Allow him to sit on his parent's lap until time to suture the laceration.

"Delays are normal when a child is premature." When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse

"Does he move a toy back and forth from one hand to the other when you give it to him?"

A nurse is providing health promotion education to a family of an infant at the family birth center. The nurse knows the parents need more education when they state which response?

"I will switch to whole milk when my baby is around 6 months of age."

The family caregiver of an 8 month old infant makes the statement, "I can't leave the room he is in because when I do he cries." Which of the following statements is most appropriate for the nurse to respond?

"If he cannot see you he thinks you are gone and that is frightening."

The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her baby crying. Which is the best response from the nurse to help this mother?

"If he cannot see you he thinks you are gone and that is frightening."

An elementary school nurse is leading a group session discussing nutrition with a group of students and their caregivers. The nurse should provide additional teaching if which statement is made by one of the participants?

"If my child has good nutrition she won't get childhood illnesses."

8 pounds and grown 4-6 inches

Which activity should the nurse encourage a new mother to perform to foster the developmental tasks of a toddler according to Erikson's developmental stages?

Allow the child to pull a talking duck toy.

Parents complain of being "worn out" at their child's 6-month check-up because their boy awakens each night and cries. The nurse suggests which measures? Select all that apply.

At bedtime, rock the child to sleep and then place in crib. Bedtime rituals and minimal interactions during night awakening both promote sleep. Adding rice cereal to bottles does not promote sleeping through the night and isn't recommended. Putting the infant asleep into the crib does not teach the child to self-soothe and fall asleep independently.

Sonograms demonstrate thumb sucking as early as in utero. a) False b) True

The mother of an 8-year-old is concerned her child is developing too slowly when compared to a cousin. Which activities, based on Piaget's theories, would the nurse predict this child should be active in?

Can classify and organize information about their environment According to Piaget, the concrete operations phase should occur at the ages of 7 to 11 years. The child develops the ability to begin problem solving in a concrete, systematic way during this stage. Demonstrating an understanding of cause and effect occurs at the ages of 0 to 2 years and occurs in the sensorimotor phase, Between the ages of 12 to 15 years, the formal operations phase occurs and involves understanding abstract concepts which are described only in words or symbols. The preoperational phase is noted at ages 2 to 7 years and this child has no concept of quantity; if it looks like more, it is more.

What information would you include when teaching the parents of an infant about colic?

Colic symptoms will probably fade at 3 months of age.

An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?

Ensure that the child brushes his teeth after each meal and snacks.

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which of the following recommendations will best help the child feed effectively?

Maintaining a feed-on-demand approach.

The school nurse is caring for several children who witnessed an 8-year-old girl get hit by car on the way to school. Which intervention is least important to the nursing plan of care for these children?

Making phone calls to the parents of the children counseled Making phone calls to the parents of the children who were determined to need counseling is least important to the nursing plan of care. It is, no doubt, mandatory for the nurse to inform and support the parents. However, this intervention is the least important based on the nursing diagnosis of the children's need for counseling, the intervention to arrange for a counselor, and the adaptation of the intervention by providing counseling for the friends of the injured child.

While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which of the following developmental phenomena has this infant demonstrated?

Object permanence Explanation: By 10 months, an infant looks under a towel or around a corner for a concealed object (beginning of object permanence, or become aware an object out of sight still exists). Hand regard, which is typically demonstrated by 3-month-olds, is phenomenon that involves the infant holding his hands in front of his face and studying them. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when they follow moving objects with their eyes. Depth perception allows 7-month-olds to transfer toys from hand to hand.

A nurse is discussing oral care with the parents of 4-year-old. The nurse determines that the parents are performing this aspect of their child's care appropriately when they state that they use which amount of toothpaste?

Pea-sized

A nurse notices that a 4-month-old infant has an asymmetric head, with the back of the skull flattened. Which of the following should she recommend to the parents to correct this condition?

Place the infant on her stomach during play time each day

The nurse is concerned that a 9-month-old baby is gaining too much weight. What should the nurse instruct the parents to help control the baby's weight gain?

Provide whole-grain cereal for one feeding.

The nurse is observing a 6-month-old boy for developmental progress. Which of the following milestones would be typical for him?

Puts down a little ball to pick up a stuffed toy

The nurse is providing anticipatory guidance to the mother of a 1-week-old girl. Which of the following is reason for the mother to contact her care provider?

Rectal temperature is greater than 100.4F

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:

Refer the infant for developmental and/or neurologic evaluation. There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.

Using knowledge of normal growth and development, what would be expected when observing a 12-week-old infant?

The infant smiles at significant others

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother:

The newborn's stomach can hold between one-half to 1 ounce

Sonograms demonstrate thumb sucking as early as in utero.

True

The developmental task of the toddler period, according to Erikson, is achieving a sense of:

autonomy.

By what age should the child know his/her own gender? a) 1 b) 4 c) 2 d) 3

d) 3 Explanation: By the age of three, the child should know his or her own gender. The other age ranges are incorrect.

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

"Baby can sleep in your room in an infant crib, but not in an adult bed."

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

"Baby can sleep in your room in an infant crib, but not in an adult bed." According to the 2016 recommendation by the American Academy of Pediatrics, infants should sleep in the same bedroom as the parents, but on a separate firm surface, such as a crib or bassinet, and never on a couch, armchair or adult bed, to decrease the risks of sleep-related deaths

A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how?

"Bed sharing has positive effects on babies, let me get you information." Explanation: The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen.

The infant weighs 7 lb 4 oz (3,248 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?

21 lb 12 oz (9.9 kg) By 1 year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The infant weighs 7pounds,4 oz at birth. If the infant is following a normal pattern of growth, what would the child weigh at the age of 12 months?

21 lbs 12 ounces: By 1 year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches. Pg. 64

The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months?

21 lbs. 12 oz. Explanation: By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The infant weighs 7 lbs. 4 oz. (3.3 kg) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? You selected: 25 lbs. (11.3 kg)

21 lbs. 12 oz. (9.9 kg)

The infant weighs 7 lbs. 4 oz. (3.3 kg) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?

21 lbs. 12 oz. (9.9 kg) By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit?

24 pounds (10.8 kg) and 30 inches (75 cm)

"Bottles given at bedtime can cause erosion of the enamel on the teeth." Explanation: The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable (D) and a pacifier will satisfy the sucking need (C), the most appropriate response is B. Giving a bottle at bedtime is not a factor that leads to obesity.

"Does he move a toy back and forth from one hand to the other when you give it to him?" Explanation: Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.

During a well-baby visit, the mother of a 3-month-old infant tells the nurse that she does not understand why her baby continues to spit out food during feeding of solid foods. What is the best response by the nurse?

"Infants still have a tongue protrusion reflex until 4 to 6 months so they can't help but push out the solid food." Explanation: Introducing solid food with a spoon prior to 4 to 6 months of age will result in extrusion of the tongue. The parent may think that the infant does not want the food and is spitting it out intentionally, but the extrusion reflex is still present.

Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie?

"It is a personal decision, let me give you a pamphlet from the AAP."

A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate?

"Keep the baby sitting up for about 30 minutes afterward."

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction?

"Maturation refers to the child's increases in body size." Growth refers to an increase in physical size. Development is the sequential process by which infants and children gain various skills and functions. Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement. Maturation refers to an increase in functionality of various body systems or developmental skills. Page 64

"You are doing a wonderful job attempting to waken the baby." The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.

24 pounds (10.8 kg) and 30 inches (75 cm) Explanation: By 1 year of age, the infant should have tripled his or her birth weight and grown 10 to 12 inches (25 to 30 cm). If this infant was 8 pounds (3.6 kg) at birth, at 1 year, this child should weigh 24 pounds (8 x 3 = 24) and grown to 30 to 32 inches (20 + 10 to 12 = 30 to 32 inches). Most of the growing occurs during the first 6 months with the infant's birth weight doubling and height increasing about 6 inches (15 cm). Growth slows slightly during the second 6 months but is still rapid.

The infant measures 21 ½ inches (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of six months?

27 ½ inches (69.9 cm)

The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply.

A mother places her newborn on its side after falling asleep/A mother states all of her children like sleeping on their abdomen and this newborn likes it too/A mother places the baby comforter her grandmother made over the newborn's body/A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off: Newborns and infants should be on their backs when sleeping in order to help prevent sudden infant death syndrome (SIDS). a firm mattress without pillows or comforters should also be used. The baby's bed should be placed away from air conditioner vents, open windows, and open heaters. pg 87

A nurse is caring for a hospitalized 7-year-old whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group?

A paint-by-numbers activity creating a picture

What information should you include when teaching parents about colic?

Colic symptoms usually fade at 3 months of age because kids begin to maintain a more upright position. Pg 88

A mother takes her 4-month-old to the doctor for a visit. She asks the nurse what type of baby cereal she should buy now that her child is starting solid foods. How should the nurse respond?

"You should buy rice cereal."

A mother takes her 4-month-old to the doctor for a visit. She asks the nurse what type of baby cereal she should buy now that her child is starting solid foods. How should the nurse respond?

"You should buy rice cereal." Explanation: The rice cereal should be first. The infant should be monitored for food allergies by following the rice cereal with oats, barley, and wheat. Wheat has the highest allergy reaction in infants.

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth."

The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?

Determining the mother cannot read the form It would not be legal for this mother to give consent. A mother younger than 18 years of age or never married may not be a problem in most states because she would be considered autonomous. The physician or nurse could read the consent form to a mother who cannot read plus carefully explain the medical information in terms she understood.

Infant development is best described by which statement?

Development proceeds cephalocaudally.

Infant development is best described by which of the following statements?

Development proceeds cephalocaudally. Explanation: Growth and development both proceed from head to toe, or in a cephalocaudal sequence.

Infant development is best described by which statement?

Development proceeds cephalocaudally. Growth and development both proceed from head to toe, or in a cephalocaudal sequence.

Infant development is best described by which statement?

Development proceeds cephalocaudally. Explanation: Growth and development both proceed from head to toe, or in a cephalocaudal sequence. The baby needs first to learn to lift the head. Once that developmental milestone has been achieved then progression can occur to rolling over and then learning to sit. Development proceeds in a proximodistal fashion. Skills are learned in a gross motor fashion before devolping fine motor skills. Infants may develop skills at different ages but the process is always sequential. Unless there are other problems to interfere with development, all children will develop in the same manner

An infant is breastfed. When assessing the stools, which findings would be typical?

Less constipation than bottle-fed infants Explanation: The first stool of the infant is meconium. It is the result of digestion of amniotic fluid and it is black-green color and sticky. Following that, in 1 to 2 days the infant's stools change to a yellowish-tan color. The stools of breastfed infants tend to be yellow-tan. They are looser in texture and appear "seedy." The stool of a bottle-fed baby has the consistency of peanut butter. The stools of breastfed babies generally have no odor since all milk is digested. Some babies will have a bowel movement with every feeding but it is small. Bottle-fed babies have less stools each day but they are larger and more likely to have an associated odor.

The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is the priority to promote adequate growth?

Monitoring the child's weight and height

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex.

Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order. You selected: Remove the preschooler to a boring spot. Set a timer for no more than 4 minutes. Parent knows the misbehavior was intentional. If the child gets up, replace the child and restart the time. Warn the child there will be a time-out if the behavior does not stop.

Parent knows the misbehavior was intentional. Warn the child there will be a time-out if the behavior does not stop. Remove the preschooler to a boring spot. Set a timer for no more than 4 minutes. If the child gets up, replace the child and restart the time. Explanation: Time-out is an extinction method of discipline that avoids reinforcing the unacceptable behavior with attention. One minute per year of age is the appropriate length of a time-out. Five minutes is the recommended maximum length.

The nurse is teaching the parents of a 6-month-old boy about proper child dental care. Which action will the nurse indicate as the most likely to cause dental caries?

Putting the baby to bed with a bottle of milk or juice

The best way for an infant's father to help his child complete the developmental task of the first year is to:

Respond to her consistently.

At what age would it be okay to introduce carrots to an infant's diet?

Solid food can be introduced at 4 to 6 months of age.

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate?

Advising how to create a toddler-safe home

The nurse in a community clinic is assessing a 4-week-old infant. The mother asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 4 weeks of age?

The infant raises head and chest while on stomach

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which of the following observations needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near.

When preforming neurological reflexes on the infant, which primitive reflex will be present longest? a) Moro b) Babinski c) Rooting d) Step

When teaching an infant's mother about bathing her, it would be important to instruct her that:

bath time provides an opportunity for play.

When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:

parallel play.

When childproofing the home for a toddler, the most important thing her parents should consider is to:

put medicine in a locked cupboard.

The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:

when the first tooth erupts: Toothbrushing should begin with the eruption of the first tooth. Pg 87

The nurse is reveiwing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?

Iron

"The soft spot or fontanel has closed." The anterior fontanel traditionally closes between 12 and 18 months. In some infants this may close sooner. This does not indicate there is any abnormality in the development of the infant.

"The soft spot or fontanel has closed." Explanation: The anterior fontanel traditionally closes between 12 and 18 months. In some infants this may close sooner. This does not indicate there is any abnormality in the development of the infant.

"The soft spot or fontanel has closed." -The anterior fontanel traditionally closes between 12 and 18 months. In some infants this may close sooner. This does not indicate there is any abnormality in the development of the infant.

"Bottles given at bedtime can cause erosion of the enamel on the teeth." The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable and a pacifier will satisfy the sucking need, the most appropriate response is to warn of possible enamel erosion. Giving a bottle at bedtime is not a factor that leads to obesity

"Delays are normal when a child is premature."

What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?

"I give my daughter juice at breakfast and when she is thirsty during the day."

A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?

"In two months you can try bananas if you think she is ready."

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this." The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating.

The maximum time-out duration is how many minutes for each year of age?

1 minute

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this?

A regular routine and rituals will provide stability and security.

The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply. a) A mother places the baby comforter her grandmother made over the newborn's body b) A mother places her newborn on its side after falling asleep c) A mother states all of her children like sleeping on their abdomen and this newborn likes it too d) A mother tells her husband to be sure to place the newborn on his back when putting the baby in the bassinet e) A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off

A, B, C, E

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply. a) The infant does not pay attention to noises behind him. b) The infant seems disinterested in the surrounding environment. c) The infant babbles. d) The infant has frequent episodes of crossed eyes. e) The infant is unable string together 2 word sentences.

A, B, D

What is the appropriate time when children should be taught genitalia terminology and about personal privacy?

Early childhood

What mineral is an important factor in tooth development?

Fluoride

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? - "Maturation refers to the child's increases in body size. -"Development refers to the increase in skills the child demonstrates as they grow and age." -"Increases in body size are referred to as growth." -"Both growth and development are influenced by heredity."

MATURATION REFERS TO AN INCREASE IN FUNCTIONALITY OF VARIOUS BODY SYSTEMS OR DEVELOPMENTAL SKILLS. Growth refers to an increase in physical size. Development is the sequential process by which infants and children gain various skills and functions. Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement.

A nurse is assisting the parents of 2-year-old who is having temper tantrums. Which of the following would the nurse encourage the parents to do once temper tantrums have started?

Move objects out of the way or move the child to prevent injury

Once temper tantrums have started, which intervention is appropriate?

Move objects out of the way or move the child to prevent injury.

The nurse is preparing a presentation for a local parent-teacher organization about the growth and development of school-age children. Which of the following would the nurse include?

Secondary sex characteristics are often embarrassing for both sexes.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently

A group of students are reviewing information about Medicaid. Which statement shows inadequate knowledge of the topic?

The federal government is responsible for administering it. Medicaid is a form of health insurance for low-income and disabled individuals. It is financed by federal and state funds and administered by the states. Medicaid is not a direct provider of service, but rather provides compensation for health care services. Federal guidelines define the scope of basic services, the extent of coverage, and certain administrative requirements. The states administer the program and determine income eligibility criteria, specific services to be covered, and payment levels and methods. pg 8

The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?

The first tooth usually erupts between 6 to 8 months.

What position is the infant placed in for "tummy time"?

The infant is placed on the floor on their tummy.

The way you would advise a toddler's mother to handle temper tantrums would be to:

appear to ignore them.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:

be able to turn over onto the back.

An overly tired school-aged child enters the school clinic. The nurse asks the child to state the times he/she usually goes to bed at night and wakes up in the morning. The child answers 11:00 PM and 6:00 AM. Which is the best response made by the nurse?

"That is not enough sleep. You should get at least 8 to 10 hours of sleep each night."

"You are doing a wonderful job attempting to wake the baby."

The nurse is meeting with a group of new mothers of infants and is leading the discussion related to weaning. Which suggestion should the nurse prioritize to this group of mothers concerning weaning their infant?

"It is important to let the infant set the pace for weaning, no matter what age they are."

A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially?

Check the expiration date on the car seat

What information would you include when teaching the parents of an infant about colic?

Colic symptoms will probably fade at 3 months of age. -probably because children begin to maintain a more upright position at that time.

A school-age child has demonstrated the ability to recognize several aspects of a problem at the same time and to understand cause and effect. The nurse should document the presence of which concept?

Decentration

While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following?

Deferred imitation

A mother calls the clinic every couple of weeks concerned that her infant is not developing appropriately. What would be an appropriate nursing diagnosis for the nurse to assign to this client?

Deficient knowledge related to normal infant growth and development

Deficient parental knowledge related to inappropriate method for toilet training

Delays are normal with premature birth. Pg 64

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?

Document as normal: The anterior fontanel most often closes between 12 and 18 months of age. It may normally close as early as 9 months of age. The closure of the fontanel at 10 months of age, while somewhat early, does not signal any health issues for the infant. Pg 65

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?

Document the findings as normal.

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?

Document the findings as normal. The anterior fontanel most often closes between 12 and 18 months of age. It may normally close as early as 9 months of age. The closure of the fontanel at 10 months of age, while somewhat early, does not signal any health issues for the infant.

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?

Document the findings as normal. -The anterior fontanel most often closes between 12 and 18 months of age. It may normally close as early as 9 months of age. The closure of the fontanel at 10 months of age, while somewhat early, does not signal any health issues for the infant.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?

Newborn

The infant will most likely present with developmental skills consistent with a 6-month-old infant. When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks or 2 months premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months.

The infant will most likely present with developmental skills consistent with a 6-month-old infant. -When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age.

The infant will most likely present with developmental skills consistent with a 6-month-old infant. Correct

The infant will most likely present with developmental skills consistent with a 6-month-old infant. Explanation: When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks or 2 months premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months

A child with a serious health condition has been hospitalized to undergo treatments. After a week of treatment the physicians have determined that the child has only weeks to live. What is the most likely initial course of action the nurse can anticipate?

The physician will confer with the parents to outline the severity of the child's condition. When a child is not expected to recover, steps will be taken to review the care being provided. The parents will be told of the expected outlook for the child followed by likely recommendations to discontinue treatment and focus on comfort measures. Although orders may be received to withhold resuscitation, a conference with the parents is indicated first. There is no need at this time to notify the facility's ethics committee

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?

Use the crib for sleeping only, not for play activities.: A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern. pg 87

When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?

Weight is above an expected range and height is within an expected range. The preschool period is one of slow growth. The child gains about 3 to 5 lb each year (1.4 to 2.3 kg) and grows about 2.5 inches (6.3 cm). The child's weight is above the expected gain and the height is what would be expected.

The best way for an infant's parent to help the child complete the developmental task of the first year is to:

respond to the infant consistently. Explanation: The developmental task of an infant is gaining a sense of trust. The infant develops this sense from the caretakers who respond to the child's needs, such as feeding, changing diapers, being held. It is a continuous process. A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust. An infant is too young to have variability in caretakers. This causes mistrust. The parents or caretakers do not need a special time to talk to the infant each day. It should be done with each interaction. Providing too much stimulus before the infant develops gross motor skills causes frustration from the child and not enjoyment.

seizures are not provoked; temper tantrums are.

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

should have disappeared This primitive (not protective) reflex should be present at birth and disappear around age 4 months.

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

should have disappeared.

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures.

step, root, morro, palmer, plantar, babinski

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:

the newborn's stomach can hold between one-half and 1 ounce. Correct

The nurse enters her patient's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her patient about breast-feeding an infant with this diagnosis?

" You can still attempt breast-feeding; let me call a lactation consultant for you." Explanation: The nurse should be therapeutic in her response and reassure the mother that breast-feeding may still be an option. Infants with cleft lips may still successfully breast-feed. The infant's feeding must be assessed, their weight monitored, and the feeding may be slower. The other responses are not therapeutic and supportive to the new mother.

A nurse is teaching parents of a 2-year-old child about discipline and limit setting. When describing the use of time out, the nurse would inform the parents that the maximum duration of time out should be how many minutes per each year of age?

1 minute

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

"Bed sharing has positive effects on babies, let me get you information." The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen.

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

"Bed sharing has positive effects on babies, let me get you information." -The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology.

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply.

"Food is so expensive. I can't afford for my child to leave any food on the plate." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." Page 86

"Delays are normal when a child is premature." Explanation: When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse.

"Delays are normal when a child is premature." -When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. Plot growth parameters and assess developmental milestones based on adjusted age.

"Do you frequently put your baby to bed with a bottle of milk or juice?"/"Is your child using a bottle for milk?"/"Does your baby use no-spill sippy cups?": Milk and juice pool around teeth leading to dental caries (tooth decay) when babies are given bottles in bed and with the use of no-spill sippy cups, so these are appropriate questions. Using a bottle after the age of 12 to 15 months can also lead to dental caries. Asking the mother, "Haven't you seen a dentist yet?" or "Did you read any of the nutrition information we send home with each visit?" are very accusatory questions and will likely make the mother very defensive. pg 87

"Does he move a toy back and forth from one hand to the other when you give it to him?" Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.

"Does he move a toy back and forth from one hand to the other when you give it to him?": Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.P73

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents?

"Food is so expensive. I can't afford for my child to leave any food on the plate."/"I have tried at least 10 times with every green vegetable and I can't get my son to like them."/"I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up.": Encouraging children to eat everything on their plate can lead to overeating and obesity. Children may need to be exposed to new food at least 20 times before determining if they like it or not. Letting a child eat whatever he wants does not lead to good choices as the child matures. pg 86

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother?

"Have you spoken with your pediatrician about your observations?"

A mother is discussing her 10-month old boy with the nurse. Which comment indicates a need for teaching?

"He loves being in his walker and 'zips' around the house." Walkers are safety hazards and not recommended by the American Academy of Pediatrics. They cause falls plus promote the ability to reach items on surfaces otherwise inaccessible. The other comments are age appropriate and acceptable practice.

A student nurse shares an interest in pediatric nursing. When discussing her thoughts about pediatric nursing, which statements are consistent with the philosophies of pediatric nursing care? Select all that apply.

"I believe the family should be included in all aspects of the plan of care and treatment." "Since health care can be scary for a child, it's important to make them feel secure." "The child should be included as much as possible in the plan of care." The three general concepts that form the philosophy of pediatric nursing care are family-centered care, atraumatic care, and evidence-based care. Pediatric nurses use these three concepts to provide quality, cost-effective care that is continuous, comprehensive, and compassionate.

A nurse is providing health promotion education to a family of an 11-month-old infant who is eating "finger foods." The nurse knows the parents understand the risk of infant choking when they state which response below?

"I can feed our baby Cheerios."

Martha asks the nurse if her 2-month-old could have baby bananas yet. The nurse would respond and educate Martha on the nutrition stages of infants by which of these responses?

"In two months you can try bananas if you think she is ready." Explanation: The nurse should choose this response because no solid foods are recommended for infants until 3 months of age. The age of 4 to 6 months is the age recommended to introduce solid foods. The other responses are the incorrect age or are letting the parent decide the appropriate answer.

A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?

"Infants still have a tongue protrusion reflex until 4 to 6 months so they can't help but push out the solid food."

"Infants still have a tongue protrusion reflex until 4 to 6 months so they can't help but push out the solid food." -Introducing solid food with a spoon prior to 4 to 6 months of age will result in extrusion of the tongue. The parent may think that the infant does not want the food and is spitting it out intentionally, but the extrusion reflex is still present

Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie?

"It is a personal decision, let me give you a pamphlet from the AAP." The nurse would not give a biased opinion and would offer Debbie literature on which to base her own decision making. The other choices offer personal views or are not supportive in educating Debbie.

The infant measures 21 ½ inches (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of six months?

27 ½ inches (69.9 cm) Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old. By 12 months of age, the infant's length has increased by 50 percent.

The nurse is evaluating if nutrition counseling for new mothers has been effective. Which comments by the mothers indicate the need for more instruction? Select all that apply.

"It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth." Either home-made pureed or pre-packaged baby food is acceptable, but neither should have any spices added to it. No-spill sippy cups actually allow juice to be in constant contact with the teeth because they are much like bottles in that the child must suck on them to get a drink.

The nurse is evaluating if nutrition counseling for new mothers has been effective. Which comments by the mothers indicate the need for more instruction? Select all that apply.

"It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth." Explanation: Either home-made pureed or pre-packaged baby food is acceptable, but neither should have any spices added to it. No-spill sippy cups actually allow juice to be in constant contact with the teeth because they are much like bottles in that the child must suck on them to get a drink.

A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother?

"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother?

"Let me ask you some more questions to see if there are symptoms of colic."

The infant measures 21.5 in. (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of 6 months?

27.5 in. (69.9 cm)

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother?

"Let me ask you some more questions to see if there are symptoms of colic." Explanation: The nurse should seek more information to assess the infant's symptoms. The symptoms suggest colic, which is characteristic of an infant who cries more than 3 hours a day and is fussy and hard to console. The other responses are non-therapeutic and do not seek further information to gather a history.

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother?

Julie is an 18-year-old new mother. When the nurse discharges the mom and infant, she notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat?

"Let me go over car seat safety with you, so you can install your car seat properly." Explanation: The nurse should notice this is not the proper place for a car seat. The car seat should be rear facing and in the center of the back seat of the car. The nurse would review car seat safety with Julie and have Julie install the seat properly. The nurse should provide written materials if available. The other responses are not appropriate and do not ensure that proper installation will occur and that infant safety will be maintained.

The nurse goes in to check on Lilly and how breast-feeding is going with her new son. The nurse observes the infant is on her lap with the blanket unwrapped, and Lilly is washing his face, and gently stroking the baby. Lily has had trouble breast-feeding the last few times. What is the appropriate response from her nurse?

"Lilly, you are doing a wonderful job attempting to waken the baby." Explanation: The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breast-fed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.

The mother of a 6-year-old Hispanic boy tells the pediatric nurse practitioner at the public health clinic that she is unable to read English. She wants to help her son so he does not have to struggle when he starts school. She wants to know how she can promote literacy even though she cannot read herself. How should the nurse respond?

"Look at books together and make up stories to go with the pictures."

The nurse comes into infant Lucy's room on the pediatric floor. She is going to try and feed her for the first time since her surgery. How does the nurse know what infant state Lucy is in by what Mom says and that it is okay to try and feed Lucy?

"Lucy has been a chatterbox and smiles just like her brother." Explanation: The best time to feed Lucy is when she is in the active alert state. Lucy is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put Lucy in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with Lucy.

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction?

"Maturation refers to the child's increases in body size.": Growth refers to an increase in physical size. Development is the sequential process by which infants and children gain various skills and functions. Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement. Maturation refers to an increase in functionality of various body systems or developmental skills.pg 64

The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. Which of the following would be the best response by the nurse?

"Milk does not provide adequate amounts of iron which are found in solid foods." Explanation: At about four to six months of age, the infant's milk consumption alone is not likely to be sufficient to meet caloric, protein, mineral, and vitamin needs. In particular the infant's iron supply becomes low, and supplements of iron-rich foods are needed.

The nurse is reinforcing teaching with a group of caregivers related to the nutritional needs of the infant. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse?

"Milk won't fully provide your child's needs for iron, which is found in solid foods."

After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur?

"My husband gave the baby a special bear that I will place in the crib."

"She has been a chatterbox and smiles just like her brother."

"She has been a chatterbox and smiles just like her brother." The best time to feed an infant is when the child is in the active alert state. This infant is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put the infant in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with the child.

The mother of a 6-week-old infant reports she doesn't know if her child recognizes her face yet. What response by the nurse is most appropriate?

"Since about 4 weeks of age your child has been able to recognize those who are around him often."

The mother of a 6-week-old infant reports she doesn't know if her child recognizes her face yet. What response by the nurse is most appropriate?

"Since about 4 weeks of age your child has been able to recognize those who are around him often." At 1 month of age the infant can recognize by sight the people he or she knows best. Telling the child's mother that this will come with time is not correct as this developmental milestone has already occurred. Telling her not to worry minimizes her questions and concerns.

"That is great that he is recognizing objects and is able to name them. He is right on target for language skills." Recognizing the parents' excitement about their child's language skills while still letting them know that this is what the expected level is for language is a polite and accurate way to respond. The other responses do not give notice to the parents' pride and would likely make the parents feel defensive about their child's skill.

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."

The infant weighs 6 lbs., 8 oz. (2.95 kg) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of four months?

13 lbs. (5.9 kg) Most infants double their birthweight by 4 months of age and triple their birth weight by the time they are 1 year old.

A frustrated mother comes to a 9-month well-baby checkup complaining to you that her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which of the following statements would be most appropriate for the nurse to say to this mother?

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this." Explanation: The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating.

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this." -The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating

A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother?

"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."

The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred?

"The cereal should be a fairly thin consistency at first."

The mother of an infant questions the nurse about her baby's teething. The nurse provides client education. Which statement by the mother indicates understanding of the information provided?

"The first teeth that will likely appear are the lower incisors."

The nurse is documenting the relationship between a postpartum mother and her infant. Which observation would demonstrate attachment?

"The mom is talking to the infant while breast-feeding the infant." The nurse would document attachment when she observes eye-to-eye contact between infant and mother, and the mother holding the infant close and talking softly with the infant. The attachment relationship occurs with eye-to eye contact, communication, and physical contact. The other choices display none of these characteristics between infant and mother.

"The soft spot or fontanel has closed."

The mother of a 11-month-old has come to the clinic with concerns. She reports to the nurse that her baby's "soft spot in the front" is now gone. The nurse assesses the infant and notes the fontanel has closed. What response by the nurse is most appropriate? -"The soft spot or fontanel has closed." -"This closure of the fontanel is very premature and warrants some further testing." -"This may signal your baby's calcium levels are elevated." -"We will need to do additional neurological testing to make certain your infant is developing normally."

"The soft spot or fontanel has closed."

A young breastfeeding mother calls the telephone nurse because she is concerned about her 3-month-old's stools. Which statement is of concern?

"The stools are foamy and smell terrible." Explanation: This may indicate a digestive problem or illness. The physician or nurse practitioner should be contacted. All the other statements describe normal stooling.

A young breastfeeding mother calls the telephone nurse because she is concerned about her 3-month-old's stools. Which statement is of concern?

"The stools are foamy and smell terrible." This may indicate a digestive problem or illness. The physician or nurse practitioner should be contacted. All the other statements describe normal stooling.

An infant has been brought to the clinic for a well-child check. The infant is 12 months of age. The child's birth weight was 6 pounds, 7 ounces. What is the anticipated weight for the child at this visit?

19 pounds, 5 ounces

A pregnant woman asks the nurse, "When should we tell our 6-year-old son that he has a new brother or sister on the way?" Which response by the nurse would be most appropriate?

"There is no best time to tell him."

The parents of a child receiving chemotherapy for leukemia notice "certified pediatric hematology/oncology nurse" on the nurse's name badge. The parents ask the nurse about this. What is the best response by the nurse?

"This certifies that I have specialized in the field of oncology/hematology care of children." While all statements may be accurate, the statement that best defines the certification, "This certification represents specialized learning that I have in the field of oncology/hematology care of children," also ensures the parents that the nurse is not just obtaining this certification for job requirements or a pay increase, but that the nurse is best prepared to care for their child.

A newly hired nurse is receiving education about the role of the facility's ethics committee during the orientation period. Which statements indicate an understanding of the role of this group? Select all that apply.

"This group will review each case presented and formulate a decision for the facility." "Education concerning ethics is a role of the committee." "The role of the ethics committee has increased over the years." Ethics committees are formulated to assist a facility in making ethical decisions. These committees not only provide case-by-case review and resolution of ethical dilemmas but also review existing institutional policies and provide education to staff, physicians, children, and families on ethical issues. As technology has advanced, ethical dilemmas have increased and made the role of the committees more important over time.

A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation?

"This is normal behavior for infants unless the stool passed is hard and dry."

The caregiver of 7-month-old twins tells the nurse that she has noticed that both of her children enjoy playing with a toy by moving the object back and forth between their hands over and over again. Which statement made by the nurse most accurately explains this behavior?

"This is one of the ways that infants develop their fine motor skills." Transferring objects is one of the manifestations of fine motor skills development, which is not fully mastered by this early age. References to nerve endings do not address the parent's query.

The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent?

"Thumb sucking is a healthy self-comforting activity."

"What does his stool look like?" Explanation: Grunting, crying and straining during bowel movements by infants and newborns is normal. This is due to the immaturity of the gastrointestinal system. The most important thing to do initially is to determine the appearance of the stool. The grunts and cries are not of concern unless the stool is dry and hard, so asking about the characteristics is the initial response. Simply indicating this is normal without having additional information is not the appropriate response. There is no need for a stool specimen based upon the infomation provided

A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking?

"We had to sign the form right away so the surgery could get scheduled." The statement about signing the form right away suggests that the family was coerced into agreeing to the surgery without being fully informed about the risks and benefits. The key ethical issues related to informed consent for treatment have similarities to those required for research participation: Consent must be voluntary and based upon shared information about the risks and benefits of the treatment. Furthermore, the parent must understand the information and be cognitively and mentally competent to make the decision. The statements about risks, activity limitations, and postoperative care indicate that information was shared with them and that they understood it.

"What does his stool look like?" -Grunting, crying and straining during bowel movements by infants and newborns is normal. This is due to the immaturity of the gastrointestinal system. The most important thing to do initially is to determine the appearance of the stool. The grunts and cries are not of concern unless the stool is dry and hard, so asking about the characteristics is the initial response.

"What does his stool look like?" Grunting, crying and straining during bowel movements by infants and newborns is normal. This is due to the immaturity of the gastrointestinal system. The most important thing to do initially is to determine the appearance of the stool. The grunts and cries are not of concern unless the stool is dry and hard, so asking about the characteristics is the initial response. Simply indicating this is normal without having additional information is not the appropriate response. There is no need for a stool specimen based upon the infomation provided.

"What does his stool look like?": Grunting, crying and straining during bowel movements by infants and newborns is normal. This is due to the immaturity of the gastrointestinal system. The most important thing to do initially is to determine the appearance of the stool. The grunts and cries are not of concern unless the stool is dry and hard, so asking about the characteristics is the initial response. Simply indicating this is normal without having additional information is not the appropriate response. There is no need for a stool specimen based upon the information provided. Pg 69

The nurse is conducting a class for new parents of infants. The nurse determines the session is successful when the parents correctly choose which instruction concerning bathing their infant?

"When I bathe my baby, I shampoo his hair each time as well."

After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching?

"When my 3-year-old asks 'Why?' all the time, this is completely normal."

"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out."

19 pounds, 5 ounces Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old. Page 64

The nurse is conducting a routine well-child evaluation for a family with five children. The mother seems frazzled, and the two oldest boys are engrossed in their hand-held video games. The other three children—all preschoolers—are gathered around a portable DVD player watching a movie while they wait for their appointment. The nurse suspects that the children spend a great deal of time in front of electronic screens and that her values greatly differ from this family's. How should the nurse approach the issue of television exposure during this evaluation?

"Would you like a pamphlet telling how TV watching affects children's health?"

"You are doing a wonderful job attempting to wake the baby." Explanation: The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.

"You are doing a wonderful job attempting to waken the baby."

"You are doing a wonderful job attempting to waken the baby." -The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period

A nurse is taking a history at the office of a 3-month-old infant with colic. The parents are upset and frustrated. Which of the following responses by the nurse is most appropriate?

"You are not bad parents."

The parents of a child on a pediatric unit are concerned with the plan of care the physician has provided. The parents ask the nurse if they may seek a second opinion if they are not in agreement with the plan of care. How should the nurse respond?

"You can always seek a second opinion if not in agreement with the current plan of care." As a child and family advocate, the nurse safeguards and advances the interests of children and their families by knowing their needs and resources, informing them of their rights and options, and assisting them to make informed decisions. The nurse in this situation has listened to the concerns of the parents and provided information to help assist them to make an informed decision about seeking a second opinion.

Bob and Nancy have financial issues and ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents?

"You can use the crib, but there are guidelines to follow." Explanation: The nurse would educate the parents on the latest guidelines for using baby cribs and provide them with available safety and information pamphlets. All cribs made after 1973 have specific safety guidelines and standards. The other responses do not provide the correct available information or educate the parents on safety standards.

Stacy is going to visit her son in the intensive care unit. She has been pumping breast milk and storing it in the fridge. Stacy is making her son's bottle for his feeding and goes to warm the breast milk. What option should the nurse give the mom to prepare the bottle?

"You can use the hot water tap to get warm water to warm the bottle." The nurse should recommend using warm water or a warm-water tap to place the bottle in before feeding. A microwave should never be used; it could create hot spots and burn the infant. The other choices are not recommended and can cause stomach discomfort. Page 85

"You may be right since infants can sense their mother's smell as early as 7 days old. The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell.

"You may be right since infants can sense their mother's smell as early as 7 days old."

The nurse enters her client's room and finds the infant on a pillow with a bottle propped up while the mother is dressing. What statement should the nurse make?

"You should always hold your baby for feedings instead of propping the bottles."

The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. What reaction should the nurse make?

"You should always hold your baby for feedings instead of propping the bottles." Explanation: The nurse should educate the mother on the risks of propping bottles with infants. Infants are at risk for aspiration of milk and for otitis media. The other choices do not point out the safety risks or educate the mother.

A mother asks the nurse where the microwave is so that she can warm up breastmilk to feed her baby. What is the best response by the nurse?

"You should warm the milk under warm water instead."

A mother asks the nurse where the microwave is so that she can warm up breastmilk to feed her baby. What is the best response by the nurse?

"You should warm the milk under warm water instead." Explanation: A microwave can heat unevenly and cause burns and therefore should never be used to heat breastmilk or formula for an infant. In addition, it can change the immune properties of the breastmilk.

"Your baby has lost a bit more than the normal amount." Explanation: The normal newborn may lose up to 10% of their birth weight. The baby in question has lost just below this amount. This will likely not require hospitalization. Expressing to the mother that her baby will likely be hospitalized is rash and will most likely not occur.

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate? -"Babies do not each much." -"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth." -"You need to make certain to burp him more frequently." -"It is too soon to determine a milk intolerance."

"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth."

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth." At the time of birth an infant's stomach can only hold 1/2 to 1 ounce. This will gradually increase. While it is true that the infant does not eat much this does not meet the educational needs of the mother and is not the best response. Burping is a part of normal newborn feeding practices but is not the best response. There is no indication there is a milk intolerance from the information reported.

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth." Explanation: At the time of birth an infant's stomach can only hold 1/2 to 1 ounce. This will gradually increase. While it is true that the infant does not eat much this does not meet the educational needs of the mother and is not the best response. Burping is a part of normal newborn feeding practices but is not the best response. There is no indication there is a milk intolerance from the information reported.

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth." -At the time of birth an infant's stomach can only hold 1/2 to 1 ounce. This will gradually increase.

A nurse is talking with the mother of a 2 ½ -year-old who is starting toilet training. The nurse determines that the child is the stage of toilet learning when the mother states which of the following? Select all that apply.

'He says he wants to wear "big-boy" pants' "He can pull his pants up and down by himself."

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply.

- "Food is so expensive. I can't afford for my child to leave any food on the plate." - "I have tried at least 10 times with every green vegetable and I can't get my son to like them." - "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up."

Based on the nursing diagnosis: Caregiver role strain related to infant crying throughout night as evidenced by parents stating, "We are exhausted." Which nursing interventions are included in the plan of care?

--During night awakening, keep interactions minimal.--Having one parent awake at a time with infant.--Establish a quieting ritual for infant before bed: encourage infant to sleep/provide a time for parents to sleep decreases caregiver role strain. Bedtime rituals/minimal interactions during night awakening both promote sleep. Also having only one parent awake allows for the other parent to rest decreasing parent exhaustion. Pg. 87

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.

-The infant does not pay attention to noises behind him.--The infant has frequent episodes of crossed eyes.--The infant seems disinterested in the surrounding environment: Warning signs that may indicate problems with sensory development include the following: young infant doesn't respond to loud noises; does not focus on a near object; does not start to make sounds or babble by 4 mths old; doesn't turn to locate sound at age 4 mths; crosses eyes most of the time at age 6 mths. Lang. dev. at this stage doesn't include stringing together 2word sent. Pg 74

When planning activities for school-age children, the nurse organizes games that include competition. At which age are these kinds of games preferred by children?

10 year olds

The infant weighs 6 lb 8 oz (2,912 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 4 months?

13 lb (5.9 kg)

The infant weighs 6 lbs., 8 oz. (2.95 kg) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of four months?

13 lbs. (5.9 kg)

The infant weighs 6 lbs., 8 oz. (2.95 kg) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of four months?

13 lbs. (5.9 kg) Most infants double their birthweight by 4 months of age and triple their birth weight by the time they are 1 year old.

A 6-month-old arrives for a well-baby visit with a case of diaper rash. The baby's mother tells the nurse she is not concerned and believes this to be normal. She reports that she changes the baby's diaper when he wakes up and before she puts him in his crib for naps or bedtime. It would be important to teach this mother that she should start checking his diaper to see if it needs changing every

2-4 hours Explanation: To prevent diaper rash, soiled diapers should be changed frequently. Check every 2-4 hours while the infant is awake to see if the diaper is soiled. Waking the baby to change the diaper is not necessary.

The infant measures 21 ½ inches (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of six months?

The infant weighs 7 lb 4 oz (3,248 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?

21 lb 12 oz (9.9 kg)

24lbs, 30in: By 1 year of age, the infant should have tripled his or her birth weight and grown 10 to 12 inches (25 to 30 cm). If this infant was 8 pounds (3.6 kg) at birth, at 1 year, this child should weigh 24 pounds (8 x 3 = 24) and grown to 30 to 32 inches (20 + 10 to 12 = 30 to 32 inches). Most of the growing occurs during the first 6 months with the infant's birth weight doubling and height increasing about 6 inches (15 cm). Growth slows slightly during the second 6 months but is still rapid. Pg 64

The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months?

27 ½ inches Explanation: Most infants double their birthweight by 4 months of age and triple their birthweight by the time they are 1 year old. By 12 months of age, the infant's length has increased by 50 percent.

The toddler grows about how many inches in height per year?

3 inches

The infant measured 20 inches (50.8 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months?

30 to 32 inches (76.2 to 81.3 cm)

The infant measured 20 inches (50.8 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months?

30 to 32 inches (76.2 to 81.3 cm) -By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months?

30-32 inches Explanation: By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The school nurse is calculating the morbidity rate of an elementary school's absenteeism related to a highly communicable infection that has been present in the school over the last two weeks. Today the school has 127 of its 300 students absent. What is the morbidity rate that the nurse will report?

42.3

If the child is gaining weight at an expected rate, a child who weighs 36 pounds (16.3 kg) at 3 years of age would weigh what amount at age 5?

44 lb (20 kg) The preschool age child gains about 4 to 5 lb each year (1.8 to 2.3 kg) and grows about 2.5 to 3 inches (6.3 cm).

What is the correct amount of wet diapers a mature infant should have each day?

6-8 per day: Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 mL/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day.-Kyle/Carman:3rd ed. p.89

A nurse is working with the local community on promoting physical fitness for children. The nurse encourages the community to develop programs that meet the needs of the school-aged child for physical activity, based on the understanding that this age group requires how much physical activity daily?

60 minutes

8 pounds and grown 4-6 inches Explanation: During the first 6 months, an infant's birth weight doubles and his or her height increases by about 6 inches. Growth slows slightly during the second 6 months but is still rapid. By 1 year of age, the infant has tripled his or her birth weight and has grown 10 inches to 12 inches.

A mother is concerned that her infant is not gaining adequate weight. The baby is 6 weeks old. Birth weight was 7 pounds 8 ounces (3,400 g). The child should weigh about __________________.

9 pounds (4.32 kg) The child should gain about 20 to 30 g daily while making up the common 10% weight loss following birth.

Which child represents an increasingly common pediatric medical scenario currently present in the United States?

9-year-old girl diagnosed with type 2 diabetes The incidence of diabetes is rising in the United States. This is not noted to be the case with congenital anomalies, trauma or lymphoma.

A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours but seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. What should be the primary nursing diagnosis in this situation? a) Risk for aspiration related to feeding the infant an inappropriate food b) Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food c) Readiness for enhanced nutrition, related to the age of the infant d) Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food

A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a) looking for a toy in her crib at the last place she saw it. b) shaking a rattle to enjoy the sound. c) pushing a spoon from her high chair tray to the floor. d) smiling at herself in the mirror.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will: a) be able to turn over onto the back. b) develop a fear of strangers. c) insist on things being done her way. d) have many "blue" or moody periods.

At what age would it be okay to introduce carrots to an infant's diet? a) Solid food can be introduced at 4 to 6 months of age. b) Solid food can be introduced at 9 months of age. c) Solid food can be introduced whenever the child seems ready. d) Solid food can be introduced at 7 to 9 months of age.

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother? a) "Let me ask you some more questions to see if there are symptoms of colic." b) "Yes, maybe she is just tired." c) "Yes, infants cry all the time at that age." d) "No, call your doctor."

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate? a) "Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth." b) "You need to make certain to burp him more frequently." c) "It is too soon to determine a milk intolerance." d) "Babies do not each much."

The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1? a) Understands "no" and other simple commands b) Squeals and makes pleasure sound c) Uses speech-like rhythm when talking with an adult d) Uses multisyllabic babbling

The nurse enters her client's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her client about breast-feeding an infant with this diagnosis? a) " You can still attempt breast-feeding; let me call a lactation consultant for you." b) "I am so sorry your infant has that problem, maybe next time." c) "Sometimes dreams do not come true." d) "I am so sorry, looks like bottle-feeding for you."

The nurse goes in to check on a new mother to see how breast-feeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse? a) "You are doing a wonderful job attempting to waken the baby." b) "You will never get him to eat all unwrapped like that." c) "That is not how you get him to eat." d) "Maybe you should watch the breastfeeding video again."

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? a) No teeth b) 1 upper tooth c) 1 to 2 lower teeth d) 1 to 3 natal teeth

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) They put her to bed when she falls asleep. b) The child has a regular, scheduled bedtime. c) They sing to her before she goes to sleep. d) If she is safe, they lie her down and leave.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that: a) the newborn's stomach can hold between one-half and 1 ounce. b) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night. c) the best feeding schedule offers food every 4 to 6 hours. d) most newborns need to eat about 4 times per day.

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern? a) Head size has increased 5 in (12 cm) since birth. b) The child weighs 10 lb 2 oz (4.6 kg). c) The child measures 21 in (53 cm) in length. d) The child exhibits palmar grasp reflex.

The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments? a) The infant will most likely present with developmental skills consistent with a 6-month-old infant. b) The infant will likely show the skills of an infant with the adjusted age of 7 month. c) By 8 months of age, the child's skill level will vary greatly and cannot be predicted. d) The infant can be expected to display developmental skills consistent with a 8-month-old infant.

The parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse? a) "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks." b) "Babies will begin to rapidly regain weight and will double birth weight around 6 months of age." c) "Babies may lose up to 10% of their body weight in the first month of life." d) "Weight loss after birth is normal."

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? a) "Maturation refers to the child's increases in body size." b) "Both growth and development are influenced by heredity." c) "Increases in body size are referred to as growth." d) "Development refers to the increase in skills the child demonstrates as they grow and age."

Two parents who have financial issues ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents? a) "You can use the crib, but there are guidelines to follow." b) "You should just buy a new crib to be on the safe side." c) "No, you cannot use a borrowed crib." d) "You can use any crib that you want."

What information would you include when teaching the parents of an infant about colic? a) Colic symptoms will probably fade at 3 months of age. b) Symptoms will decrease if she is laid on her back after feedings. c) Their child will need future follow-up for a "nervous" bowel. d) Formula intake should be doubled to keep her from losing weight.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Sitting independently b) Walking independently c) Building a tower of four cubes d) Turning a doorknob

Which milestone would you expect an infant to accomplish by 8 months of age? a) Sitting without support b) Creeping on all fours c) Being able to sit from a standing position d) Pulling self to a standing position

A tantrum preceded the event.

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath Explanation: The rubber duck is most appropriate. It is safe, is visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath The rubber duck is most appropriate. It is safe, visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys. Page 73

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath The rubber duck is most appropriate. It is safe, is visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.

The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. a) Telling the mother this behavior usually decreases by 6 to 9 months of age b) Informing the mother that thumb sucking occurs more often during periods of stress c) Assuring the mother this behavior won't cause malocclusion d) Advising the mother this behavior is a form of self-comfort

A, B, C, D

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response? a) "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." b) "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous system control." c) "The best time to start toilet training is as soon as the child begins walking." d) "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do."

A- "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." The markers of readiness are subtle, but as a rule children are ready for toilet training when they begin to be uncomfortable in wet diapers. They demonstrate this by pulling or tugging at soiled diapers. Because physiologic development is cephalocaudal, the rectal and urethral sphincters are not mature enough for control in most children until at least the end of the first year, when tracts of the spinal cord are myelinated to the anal level. A good way for a parent to know a child's development has reached this point is to wait until the child can walk well independently. Toilet training need not start this early, however, because cognitively and socially, many children do not understand what is being asked of them until they are 2 or even 3 years old.

The mother of a preschooler reports that her daughter seems to believe in magic. She voices concern that this "fantasy world" may become a problem. What response by the nurse is indicated? Select all that apply. a) "Your daughter is engaging in what we call magical thinking." b) "This type of imagination is not normally seen until a child is school aged." c) "This type of thought process allows your daughter to begin to observe the differences in the world." d) "While imagination is normal, this type of fantasy world can cause problems for your child and should be discouraged." e) "Fantasy play is most often seen in lonely children in an attempt to occupy themselves."

A- "Your daughter is engaging in what we call magical thinking." C- "This type of thought process allows your daughter to begin to observe the differences in the world." Magical thinking is a normal part of preschool development. In magical thinking, the preschooler believes that his or her thoughts are all-powerful. The fantasy experienced through magical thinking allows the preschooler to make room in his or her world for the actual or the real. Through make-believe and magical thinking, preschool-age children satisfy their curiosity about differences in the world around them. There is nothing problematic about this type of imagination.

In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching? a) The child hides behind her bedroom door when defecating. b) The child frequently repeats words parents just said. c) The toddler walks with a wide, swaying gait. d) The child often removes her shoes and socks.

A- The child hides behind her bedroom door when defecating. Hiding while defecating indicates awareness of this need. Repeating words promotes language development but doesn't indicate readiness for toilet teaching. Walking with a wide, swaying gait is early walking behavior. Steady walking and running signals toileting readiness. Removal of shoes and socks is easily done. Greater fine motor clothing removal skill is needed for toileting.

A group of caregivers of toddlers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which statement made by these caregivers is most appropriate related to this form of discipline? a) "When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out." b) "She is 2 years old now and I put her in time out for 5 to 10 minutes when she misbehaves." c) "Our time-out chair is in the master bedroom so she can't see anyone else in the family." d) "We use the time-out chair when our son gets tired but doesn't want to take a nap."

A-"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out." A method for a child who is not cooperating or who is out of control is to send the child to a "time-out" chair. This should be a place where the child can be alone but observed without other distractions. The duration of the isolation should be limited—1 minute per year of age is usually adequate. Caregivers should warn the child in advance of this possibility, but only one warning per event is necessary.

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? a) A regular routine and rituals will provide stability and security. b) Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. c) A sense of control can be provided through offering limited choices. d) Aggressive behaviors such as hitting and biting are common in toddlers.

A-A regular routine and rituals will provide stability and security. Toddlers benefit most from routines and rituals that help them anticipate events and teach and reinforce expected behaviors. Knowing that a child can move from calm to temper tantrum very quickly, understanding the benefit of limited choices, and realizing that hitting and biting are common behaviors in toddlerhood provide information but not a guiding concept.

The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development? a) Her vocabulary is between 10 and 15 words. b) She asks many questions. c) She uses complete 3- to 4-word sentences. d) She talks incessantly.

A-Her vocabulary is between 10 and 15 words A 3-year-old child typically has a vocabulary of approximately 900 words, asks many questions, uses complete sentences consisting of 3 to 4 words, and talks incessantly. Thus a vocabulary of 10 to 15 words suggests a language problem.

The 18-month-old has most likely attained which gross motor skill? a) The ability to walk independently. b) The ability to walk up stairs alone. c) The ability to balance on one foot. d) The ability to pedal a tricycle.

A-The ability to walk independently. The 18-month-old child can walk alone, but the gait may still be a little unsteady

A 2-year-old holds his breath until he passes out when he wants something his mother does not want him to have. You would base your evaluation of whether these temper tantrums are a form of seizure on the basis that: a) seizures are not provoked; temper tantrums are. b) with seizures, cyanosis rarely develops. c) seizures typically occur with fever; temper tantrums do not. d) seizures rarely occur in toddlers.

A-seizures are not provoked; temper tantrums are. Temper tantrums occur because children are angry or frustrated; seizures occur without respect to provocation.

When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old? a) He should say 20 nouns and 4 pronouns. b) He should speak in two-word sentences ("Me go"). c) He should say two words plus "ma-ma" and "da-da." d) He should be able to count out loud to 20.

AHe should speak in two-word sentences ("Me go"). By 2 years of age, children typically speak in two-word (noun and verb) sentences.

What finding would the nurse most likely discover in a 10-year-old child in the period of concrete operational thought?

Ability to classify similar objects

The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address?

Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching?

Advising them to use praise, not scolding

The nurse is caring for a 16-year-old female who has been brought to the clinic by her mother seeking information about contraceptives. What action by the nurse will best promote the client's autonomy?

After a review of suitable contraceptive options, ask the client which is of the greatest interest. Autonomy refers to self determination and inclusion in decision making. Sharing information and allowing the teen to participate will promote autonomy. Encouraging the decision to be made by the teen does not embrace the decision making abilities of the teen. A discussion on abstinence is appropriate for inclusion but does not promote autonomy or address the reason for seeking health care.

"My husband gave the baby a special bear that I will place in the crib." Explanation: The nurse should reinforce that stuffed animals, blankets, pillows, and soft mattresses are suffocation hazards for infants.

After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur?

What is the correct amount of wet diapers a mature infant should have each day?

An infant should have 6 to 8 wet diapers/day

What is the correct amount of wet diapers a mature infant should have each day?

An infant should have 6 to 8 wet diapers/day.

What is the correct amount of wet diapers a mature infant should have each day?

An infant should have 6 to 8 wet diapers/day. Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 mL/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day.

What is the correct amount of wet diapers a mature infant should produce each day?

An infant should have 6 to 8 wet diapers/day. Explanation: Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 ml/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day.The infant should have an intake of between 140 to 160 ml/kg/day to be well hydrated and nourished. This amount of intake will produce the 6 to 8 diapers/day.

An infant is being introduced to drinking fluids from a cup. The nurse instructs the mother that fruit juice can now be added. Which of the following would the nurse suggest the mother try first? Select all that apply.

Apple White grape juice

The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be: a) by 12 months of age. b) as soon as the first tooth erupts. c) as soon as he begins to eat fruit. d) when weaning is complete.

The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.

Around 2 months the infant exhibits a first real smile. Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. Separation anxiety may also start in the last few months of infancy.

The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:

As soon as the first tooth erupts.

The nurse is caring for a child who underwent an appendectomy 12 hours ago. The child has reported incisional pain. When the nurse attempts to administer the prescribed analgesic the child's mother declines the medication. What initial action by the nurse is most appropriate?

Ask the child's mother to elaborate on her concerns about the medication. Some people may not approve of the administration of narcotics or medications containing alcohol. The nurse must first determine the cause of the concern. Then action can be taken to best provide care to the child. Continuing observation of the child does not address the needs related to pain management. Although the client's physician or the nursing supervisor may be contacted, it is not the initial action in this scenario.

The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say specific words such as mama or dada yet. What is the priority intervention?

Asking the mother if the child uses Spanish words

The nurse is providing care to a 6-year-old child following surgery. The nurse asks the child to rate the pain using the Faces of Pain scale. Which phase of the nursing process is the nurse demonstrating?

Assessment

The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. Which of the following should be included in the teaching plan? Select all that apply.

Assuring the mother this behavior won't cause malocclusion

A nursing student realizes that which of the following is true about Kohlberg's theory of moral development?

At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act.

During a well-baby visit the mother of a 3-month-old infant tells the nurse that she does not understand why her baby continues to spit out food during feeding of solid foods. What is the best response by the nurse? a) "Maybe if you make your own baby food your infant will like it better." b) "Infants still have a tongue protrusion reflex until 4 to 6 months so they can't help but push out the solid food." c) "I will make sure to let the physician know." d) "A lot of babies do this at first. Just give it some time and I'm sure your baby won't continue spitting out solid food."

During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? a) "Babies really can't tell the difference between people at that age." b) "You may be right since infants can sense their mother's smell as early as 7 days old." c) "I'm not sure a 4-week-old infant can tell their mother from another woman's smell." d) "Maybe she just knows your voice better than your mother's."

The infant measures 21 ½ inches (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of six months? a) 32 inches (81.3 cm) b) 27 ½ inches (69.9 cm) c) 30 ½ inches (77.5 cm) d) 29 inches (73.7 cm)

The infant weighs 6 lbs., 8 oz. (2.95 kg) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of four months? a) 15 lbs. 4 oz. (6.92 kg) b) 13 lbs. (5.9 kg) c) 10 lbs. 8 oz. (4.76 kg) d) 16 lbs. (7.26 kg)

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? a) The irregularity of the infant's respirations are concerning; I will notify the physician. b) The respirations of a 1-month-old infant are normally irregular and periodically pause. c) An infant at this age should have regular respirations. d) The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.

The mother of a 11-month-old has come to the clinic with concerns. She reports to the nurse that her baby's "soft spot in the front" is now gone. The nurse assesses the infant and notes the fontanel has closed. What response by the nurse is most appropriate? a) "This closure of the fontanel is very premature and warrants some further testing." b) "The soft spot or fontanel has closed." c) "We will need to do additional neurological testing to make certain your infant is developing normally." d) "This may signal your baby's calcium levels are elevated."

The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term? a) Educating the parents about when colic stops b) Urging the baby's mother to take time for herself away from the child c) Watching how the parents respond to the child d) Assessing the parents' care and feeding skills

The nurse is documenting the relationship between a postpartum mother and her infant. Which observation would demonstrate attachment? a) "The infant remains in the nursery most of the day." b) "The mom is talking to the infant while breast-feeding the infant." c) "The father is always holding the infant." d) "The infant is in the crib every time the nurse goes into the room."

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? a) A push-pull toy b) A yellow rubber duck for the bath c) Pots and pans from the kitchen cupboard d) Brightly colored stacking toy

The nurse is working with the caregivers of an infant. The caregivers tell the nurse their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and help the child develop a sense of security when the child's primary caregiver is out of sight? a) Give her dolls and stuffed animals so she learns to distract herself. b) Play "peek-a-boo" with the child when she is happy. c) Pick the child up as soon as she begins to cry. d) Slowly increase the amount of time she is allowed to cry before being picked up.

The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted? a) "Is he able to drink with a cup by himself?" b) "Does he move a toy back and forth from one hand to the other when you give it to him?" c) "Is he able to hold a pencil and scribble on paper?" d) "Does he place toys into a box or container and take them out?"

What action shows an example of Erik Erikson's developmental task for the infant? a) The infant plays the game peek-a-boo. b) The infant cries and the caregiver picks the child up. c) The infant cries when he has a wet diaper. d) The infant smiles as people walk past the crib.

Which developmental task, according to Erikson, should an infant accomplish during the infant year? a) Adaptation b) Trust c) Learning and interaction d) Autonomy

The parents of a 30-month-old girl have brought her into the emergency department because she had a seizure. During the health history, the nurse suspects the child had a breath-holding spell. Which parental report suggests breath-holding? a) The child became unconscious. b) A tantrum preceded the event. c) The child was lethargic afterward. d) The event took place during a nap.

B- A tantrum preceded the event. The fact that there was a precipitating event of frustration and anger points to the likelihood that this is a cyanotic breath-holding spell. Breath-holding spells never occur during sleep, nor do they feature postictal confusion. Unconsciousness is not definitive because it is common to both seizures and breath-holding spells.

Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? a) Tried to refocus the child's attention as tantrum behavioral cues appeared b) Reasoned with the child to stop the behavior c) Made sure the child was rested and not hungry before going to the mall d)Remained relatively calm even though embarrassed

B-Reasoned with the child to stop the behavior The child having a tantrum is out of control, making reasoning impossible. Calmly bear hugging the child provides control, especially in a public place. The other actions are helpful in preventing a tantrum.

A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to: a) pretend she does not hear him. b) give him secondary, not primary, choices. c) tell him never to say, "No" again. d) ask no further questions of him.

B-give him secondary, not primary, choices. Encouraging toddlers to express their opinion aids in developing a sense of autonomy; allowing secondary choices encourages this without disrupting family life.

When preforming neurological reflexes on the infant, which primitive reflex will be present longest?

Babinski

When preforming neurological reflexes on the infant, which primitive reflex will be present longest?

Babinski Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. Except for the Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life, giving way to protective reflexes.

When preforming neurological reflexes on the infant, which primitive reflex will be present longest?

Babinski -Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. Except for the Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life, giving way to protective reflexes

The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent?

Bath time provides an opportunity for play Explanation: The work of children is play. Play provides a natural way for the infant to learn. In early infancy infants prefer their parents rather than toys. Parents can talk and sing to infants during feeding, bathing, and changing diapers. Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.

When teaching an infant's mother about bathing her, it would be important to instruct her that:

Bath time provides an opportunity for play: Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil. Pg 79

A newborn infant requires skin care that includes bathing. Besides hygiene, what is another reason for bathing an infant?

Bathing is a time for bonding with the parents.

A newborn infant requires skin care that includes bathing. Besides hygiene, what is another reason for bathing an infant?

Bathing is a time for bonding with the parents. -The parents can use bath time for bonding with their infant. This can be done with talking, cooing, and singing. Bath time should be slow-paced and nonstressful.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:

Be able to turn over onto the back.

Which activity is most beneficial in the development of the newborn? a) Listening to classical music b) Laying on his back with a mobile overhead to watch c) Being sung to by his mother d) Placement in an infant swing in a position to allow observation of the family's activities

A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her?

Be sure to wash the infant's face, hands, and diaper area daily

A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her?

Be sure to wash the infant's face, hands, and diaper area daily. Explanation: Except in very hot weather, an infant does not need a bath every day. If a parent is tired and would not enjoy bath time or if some days are just too rushed, a complete bath can be omitted, with only the infant's face, hands, and diaper area washed. Some infants do need their head and scalp washed frequently (every day or every other day) to prevent seborrhea, a scaly scalp condition often called cradle cap. If seborrhea lesions do develop, they adhere to the scalp in yellow, crusty patches. The skin beneath them may be slightly erythematous. The patches can be softened by oiling the scalp with mineral oil or petroleum jelly and leaving it on overnight. The crusts can then be removed by shampooing the hair the next morning. A soft toothbrush or fine-toothed comb can be used to help remove them.

Which activity is most beneficial in the development of the newborn?

Being sung to by his mother

Which activity is most beneficial in the development of the newborn?

Being sung to by his mother -Interaction between the newborn and his parents is the most beneficial activity. Later toys and music may have a good influence but initially the parental interaction is best.

Which activity is most beneficial in the development of the newborn?

Being sung to by his mother: Interaction between the newborn and his parents is the most beneficial activity. Later toys and music may have a good influence but initially the parental interaction is best. pg 79

The nurse is preparing to teach a class to a group of young parents with infants the basics of introducting solid foods into the diet. Which factor about the food should the nurse point out the infants respond to best when introducng solid foods into the diet?

Bland

The school nurse is teaching parents about the effects of bullying on school children. What accurately describes this developmental concern?

Both boys and girls are bullied; boys usually bully boys and use force more often.

An infant is breast-fed. When assessing her stools, which findings would be typical?

Breast-fed infants are less likely to be constipated than bottle fed infants: The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies. Pg 69

An infant is breast-fed. When assessing her stools, which findings would be typical?

Breast-fed infants are less likely to be constipated than bottle-fed infants.

An infant is breastfed. When assessing her stools, which findings would be typical?

Breastfed infants are less likely to be constipated than bottle-fed infants -The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies.

An infant is breastfed. When assessing her stools, which findings would be typical?

Breastfed infants are less likely to be constipated than bottle-fed infants.

An infant is breastfed. When assessing her stools, which findings would be typical? -Stools of breastfed infants are usually harder than those of bottle-fed infants. -Breastfed infants usually have fewer stools than bottle-fed infants. -Breastfed infants are less likely to be constipated than bottle-fed infants. -Stools of breastfed infants tend to have a strong odor.

Breastfed infants are less likely to be constipated than bottle-fed infants.

An infant is breastfed. When assessing her stools, which of the following data would be typical?

Breastfed infants are less likely to be constipated than bottle-fed infants. Explanation: The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies.

An infant is breastfed. When assessing her stools, which findings would be typical?

Breastfed infants are less likely to be constipated than bottle-fed infants. The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines: a) The child weighs more than expected for age. b) The child weighs the expected amount for age. c) The child weighs less than expected for age. d) The weight assessment is blatantly inaccurate.

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex? a) It is not important how long the reflex persists, only that it is present at birth. b) A Moro reflex normally lasts until 9 months. c) Most 3-month-olds still have a Moro reflex. d) A Moro reflex present at 3 months of age requires referral for a neurologic exam.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a) The growth of a 5-month-old b) The development of a 10-week-old c) The development of a 3-month-old d) The growth of a 2-month-old

Using knowledge of normal growth and development, what would be expected when observing a 12-week-old infant? a) The infant is able to sit up and can roll over b) The infant grasps objects and brings them to the mouth c) The infant smiles at significant others d) The infant bears weight on legs when held in standing position

A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse? a) "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." b) "All children mature and develop at different rates so it is unwise to compare them in this way." c) "Delays are normal when a child is premature." d) "You should talk with the doctor about getting your son tested."

A frustrated mother comes to a 9-month well-baby check-up because her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother? a) "The baby might be allergic to the particular foods you offered, so try different kinds of food." b) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." c) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this." d) "The baby might not be ready for solid food, so wait a month or so and try again."

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. What would be most helpful for this mother to do to encourage healthy sleeping patterns? a) Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. b) Let the baby cry during the night and she will eventually fall back to sleep. c) Use the crib for sleeping only, not for play activities. d) Put the baby to bed at various times of the evening.

A newborn infant requires skin care that includes bathing. Besides hygiene, what is another reason for bathing an infant? a) Bathing helps moisten the skin. b) Bathing can prevent infection. c) Bathing is a time for bonding with the parents. d) Bathing is a great time to apply lotion.

A young breastfeeding mother calls the telephone nurse because she is concerned about her 3-month-old's stools. Which information indicates a possible problem? a) "Her stools are loose and seedy." b) "She hasn't had a stool for 3 days." c) "The stools are foamy and smell terrible." d) "She grunts and squirms when filling her diaper."

Infant development is best described by which statement? a) Development is not sequential but predictable. b) Development proceeds from fine to gross. c) Development proceeds cephalocaudally. d) Development varies greatly from infant to infant.

The best way for an infant's father to help his child complete the developmental task of the first year is to: a) talk to her at a special time each day. b) keep her stimulated with many toys. c) respond to her consistently. d) expose her to many caregivers to help her learn variability.

The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be: a) "Giving a bottle of milk when the infant goes to bed can lead to obesity." b) "Giving your baby a pacifier at bedtime will satisfy the need to suck." c) "Bottles given at bedtime can cause erosion of the enamel on the teeth." d) "You could occasionally give your baby a bottle of water at bedtime."

The infant weighs 7 lbs. 4 oz. (3.3 kg) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? a) 25 lbs. (11.3 kg) b) 14 lbs. 8 oz. (6.6 kg) c) 21 lbs. 12 oz. (9.9 kg) d) 28 lbs. 4 oz. (12.8 kg)

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability? a) Most babies sit steadily at 3 months; she is slightly delayed. b) Sitting ability and the age of first tooth eruption are correlated. c) Most babies do not sit steadily until 8 months; she is normal. d) Most babies sit steadily at 4 months; she is normal.

The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what infant state the child is in by what the mother says and that it is okay to try and feed the infant? a) "She is still sleeping, I guess she is worn out." b) "She is so quiet today, that is not like her." c) "She has been a chatterbox and smiles just like her brother." d) "She has been crying every time someone picks her up."

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) The child has a regular, scheduled bedtime. b) If she is safe, they lie her down and leave. c) They put her to bed when she falls asleep. d) They sing to her before she goes to sleep.

The nurse is reviewing topics to be discussed with caregivers related to caring for infants. Which statement would be the most appropriate statement for the nurse to make to this group of caregivers? a) The infant should wear hard-soled shoes in order to protect their feet from injury b) The infant should be dressed more warmly than older children and caregivers c) The infant sleeps 10-12 hours at night and take 2-3 naps during the day d) The infant should be sound asleep before being put into the crib for sleeping

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a) Actively urge the child to eat new foods b) Let the child eat only the foods she prefers c) Serve new foods several times d) Provide small portions that must be eaten

What does Erikson describe as the psychosocial development task upon which other psychosocial development is built? a) Learning to love b) Learning to fear c) Learning to trust d) Learning to feel anger

During a well-baby visit the mother tells the nurse that she thinks her baby has a decayed tooth and doesn't understand how this could have happened. What are appropriate questions for the nurse to ask this mother? Select all that apply. a) "Did you read any of the nutrition information we send home with each visit?" b) "Haven't you seen a dentist yet?" c) "Do you frequently put your baby to bed with a bottle of milk or juice?" d) "Is your child using a bottle for milk?" e) "Does your baby use no-spill sippy cups?"

C, D, E

The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet? a) "You may have to serve a new food 10 or more times." b) "Serve only healthy foods. He'll eat when he's hungry." c) "Give him more healthy choices with less junk food available." d) "Calorie requirements for toddlers are less than infants."

C-"Give him more healthy choices with less junk food available." Suggesting that the parents transition the child to a healthier diet by serving him more healthy choices along with smaller portions of junk food will reassure them that they are not starving their child. The parents would have less success with an abrupt change to healthy foods. Explaining calorie requirements and the time line for acceptance of a new food do not offer a practical reason for making a change in diet.

The mother of a 2-year-old tells you she is constantly scolding him for having wet pants. She says her son was trained at 12 months, but since he started to walk, he wets all the time. Which nursing diagnosis would be most applicable? a) Total urinary incontinence related to delayed toilet training b) Excess fluid volume related to inability to control urination c) Deficient parental knowledge related to inappropriate method for toilet training d) Ineffective coping related to lack of self-control of 2- year-old

C-Deficient parental knowledge related to inappropriate method for toilet training It is probable that a child toilet trained at 12 months was not truly trained; his mother was trained to remind him or place him on a toilet frequently during the day. When the child begins to play independently, the training is no longer effective.

A toddler's mother reports that her child will only eat peanut butter and jelly sandwiches for several days in a row. The child will then refuse to eat them for several weeks. Which term would the nurse use to document this behavior? a) Physiologic anorexia b) Echolalia c) Food jag d) Egocentrism

C-Food jag During a food jag, the toddler may prefer only one particular food for several days, then not want it for weeks. Physiologic anorexia describes the fact that toddlers do not require as much food intake for their size as they did in infancy. Echolalia is repetition of words and phrases. Egocentrism describes the focus on self that is present in toddlers.

Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which technique would the nurse most likely suggest? a) Promise a reward if she behaves. b) Tell her she is bad and will be punished. c) Use short "time-outs" and remain calm. d) Vary the response based on the situation.

C-Use short "time-outs" and remain calm. The best response to tantrums is to remain calm and use short "time-outs." Responses need to be consistent rather than varied. Telling the child she is bad is negative. Promising a reward for good behavior will result in rewarding bad behavior.

A nurse is providing care to a child on an oncology unit. The nurse is both administering chemotherapy to the child and teaching the parents about the actions, side effects, and complications of the drug. These actions best describe which nursing role?

Clinical nurse specialist The clinical nurse specialist has a master's degree and provides expertise as an educator, clinician, or researcher, meeting the needs of staff, children, and families, as demonstrated in this scenario by both administering and providing information regarding the chemotherapy. The clinical coordinator typically holds a baccalaureate degree and fills a leadership role in a variety of settings. The case manager, also usually a baccalaureate-prepared nurse, is responsible for integrating care from before admission to after discharge. The pediatric nurse practitioner provides health maintenance care for children (such as well-child examinations and developmental screenings) and diagnoses and treats common childhood illnesses. He or she manages children's health in primary, acute, or intensive care settings or provides long-term management of the child with a chronic illness.

Which of the following would you include when teaching the parents of an infant about colic?

Colic symptoms will probably fade at 3 months of age. Explanation: Colic symptoms typically fade at 3 months of age, probably because children begin to maintain a more upright position at that time.

What information would the nurse include when teaching the parents of an infant about colic?

Colic symptoms will probably fade at 3 months of age. Explanation: Colic is defined as unconsolable crying that lasts 3 hours or longer per day and which it has no physical cause. Colic symptoms typically fade around 3 months of age. This is an age when infants are better able to console themselves. Colic can be very stressful for parents and lead to sleep deprivation. Many infants need to be carried at all times to reduce crying. Some do well with non-nutritive sucking and other need white noise or motion to help them soothe. Because colic has no physical cause telling the parents about follow up for "nervous stomach" is not necessary. The infant should be placed in a position of comfort to reduce the crying. Every infant has one's own position which helps, not just placing the infant on the back. Doubling up the formula will not help colic and may cause more problems, because it can cause abdominal pain and increased weight gain.

When teaching the parents of a school-aged child about promoting adequate sleep, which instructions would the nurse emphasize? Select all that apply.

Consistent bedtime Bedtime routine

The nurse is providing education to the woman about foods commonly associated with allergies in infants and young children. What items should be included in this list? Select all that apply.

Cow's milk Peanut butter Strawberries Explanation: In infants and children, certain foods are associated with allergies. These foods include cow's milk, egg whites, peanut butter and strawberries. Soy products and egg substitutes are not among those foods associated with allergies in children.

Nursing students are reviewing developmental milestones for toddlers. They demonstrate understanding of these milestones when they put them in the proper sequence. Place the milestones in their proper sequence from earliest to latest. Name one body part Name one color Creep up stairs Engage in parallel play Run and jump in place

Creep up stairs Run and jump in place Name one body part Engage in parallel play Name one color Explanation: A 15-month-old can creep upstairs. An 18-month-old can run and jump in place and name one body part. A 24-month-old engages in parallel play; a 30-month-old can name one color.

The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which of the following should appear at this age?

Cruises around furniture At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year.

A 2-month-old body has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic? a) His mom should have a regular diet. b) He is hungry so his mom should feed him more. c) His parents should sing and play music to comfort him. d) He needs to try a different formula to assess for sensitivity.

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? a) The infant squeals with pleasure b) The infant imitates her father's cough c) The infant coos, babbles, and gurgles d) The infant says "da-da" when looking at her father

A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses? a) "When did you feed your other child bananas? b) "In one month you can try bananas if you think she is ready." c) "Sure, if you feel she is ready to have bananas." d) "In two months you can try bananas if you think she is ready."

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond? a) "Sure, you can, make sure you use a soft mattress for support." b) "Bed sharing is okay, just make sure the infant is between two people." c) "Sure, you can do whatever you want, it is your baby." d) "Bed sharing has positive effects on babies, let me get you information."

An infant is breastfed. When assessing her stools, which findings would be typical? a) Stools of breastfed infants tend to have a strong odor. b) Stools of breastfed infants are usually harder than those of bottle-fed infants. c) Breastfed infants usually have fewer stools than bottle-fed infants. d) Breastfed infants are less likely to be constipated than bottle-fed infants.

The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate? a) "Grunting is normal with infant stool formation." b) "We will need to collect a stool specimen for analysis." c) "Is he in pain?" d) "What does his stool look like?"

The mother of 1-week-old boy voices concerns about her baby's weight loss since birth. At birth the baby weighed 7 lb (3.2 kg); the baby currently weighs 6 lb 1 oz (2.8 kg). Which response by the nurse is most appropriate? a) "All babies lose a substantial amount of weight after birth." b) "Your baby has lost too much weight and may need to be hospitalized." c) "Your baby's weight loss is well within the expected range." d) "Your baby has lost a bit more than the normal amount."

The nurse is admitting a 12-month-old to the medical unit. During the admission process the parents tell the nurse that their child is very advanced because he says "ball" when he picks up a football. How should the nurse respond? a) "Parents usually think their child is far more advanced than other children." b) "He really isn't any more advanced than most 12-month-old children." c) "If he were advanced in language skills he would be putting several words together to form short sentences." d) "That is great that he is recognizing objects and is able to name them. He is right on target for language skills."

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated? a) Measure the infant's head circumference. b) Notify the infant's physician. c) Review the birth records of the infant to see if there were any other anomalies. d) Document the findings as normal.

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? a) The anterior fontanel is open and easily palpated. b) The infant grasps a finger when it is placed in his palm. c) His toes hyperextend when the bottom of the foot is stroked. d) The infant displays an asymmetric tonic neck reflex (fencing reflex).

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? a) Frequent loose stools b) Running a mild fever or vomiting c) Choosing soft foods over hard foods d) Increased biting and sucking

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective? a) The parent allows the child to continue pulling at the dog and states, "If the dog bites her she will learn." b) The parent spanks the child while taking the child into another room away from the dog c) The parent places the child in time-out and explains the reason for the time-out d) The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client? a) Infant b) Child c) Baby d) Newborn

When teaching an infant's mother about bathing her, it would be important to instruct her that: a) she should never use soap on a baby's hair. b) soap lubricates and oils an infant's skin. c) infants need a daily bath. d) bath time provides an opportunity for play.

When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? a) "I see you have a car seat, that is great." b) "You should never put the car seat in the front." c) "With the car seat in front, you can keep an eye on your baby." d) "Let me go over car seat safety with you, so you can install your car seat properly."

The mother of an 18-month-old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated? a) "Does your child have opportunities to socialize much with other children?" b) "Has your child displayed any aggressive tendencies toward other children?" c) "Perhaps you should consider a preschool to promote more socialization opportunities." d) "It is normal for children to engage in play alongside other children at this age."

D- "It is normal for children to engage in play alongside other children at this age." The social skills of the toddler at this age include parallel play. During parallel play children will play alongside each other rather than cooperatively. There is no indication that the aggression level of the child needs to be investigated. There is no indication the child needs increased socialization with other children.

What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition? a) "She drinks three 6-ounce cups of whole milk each day." b) "When she doesn't eat well at meals we give her nutritious snacks." c) "New foods are offered along with ones she likes." d) "I give my daughter juice at breakfast and when she is thirsty during the day."

D-"I give my daughter juice at breakfast and when she is thirsty during the day." High juice intake can contribute to either obesity or appetite suppression. None is needed, but if juice is given limit the amount to 4 to 6 ounces daily. Water should be the choice for thirst. The other statements support good toddler nutrition. Whole milk is needed through age 2 years. Two cups daily is adequate. Nutritious snacks support quality intake when quantity is poor. New foods offered with old ones provide sameness along with the new.

A nurse observes a child engaged in parallel play in a nursery. What is an example of parallel play? a) Two boys playing cooperatively with stuffed animals, pretending that the toys are fighting each other b) A girl sitting by herself and alternating between playing with a doll for a time and then with a toy truck for a time c) A group of children playing hide and seek on the playground d) A boy sitting beside a girl in the floor, each playing independently with a separate set of blocks

D-A boy sitting beside a girl in the floor, each playing independently with a separate set of blocks All during the toddler period, children play beside children next to them, not with them. This side-by-side play (called parallel play) is not unfriendly but is a normal developmental sequence that occurs during the toddler period. The other answers are not examples of parallel play.

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?

Document the findings as normal. Explanation: The anterior fontanel most often closes between 12 and 18 months of age. It may normally close as early as 9 months of age. The closure of the fontanel at 10 months of age, while somewhat early, does not signal any health issues for the infant.

The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated? -Document the findings as normal. -Review the birth records of the infant to see if there were any other anomalies. -Notify the infant's physician. -Measure the infant's head circumference.

The nurse is completing an infant history on a 5-month-old and documents the following symptoms. Which will the nurse attribute to teething? Select all that apply.

Drooling and biting, Increased sucking on hands, Irritability and awakening from sleep, Refusing to eat: Infants at age 5 months are in the process of cutting their first teeth, typically the upper or lower central incisors. Symptoms associated with the mouth and feeding are common. Fever and diarrhea are considered signs of illness, not teething. Pg 89

A nurse is preparing to conduct a class for a group of new parents. When discussing safety, which of the following would the nurse include as a leading cause of death in children?

Drowning

Morbidity rates among children are most highly associated with which cause?

Environmental factors The factors most commonly associated with child morbidity are environmental and socioeconomic problems. The more difficult the societal issues and the more marked the environmental poverty, the higher the illness rates and childhood morbidity. Firearms, violence in schools, homicide, and suicide are all factors in morbidity, but they are not strictly related to children.

Like many 4-year-olds, Ethan is constantly seeking out and exploring new experiences and repeatedly asking his parents why-type questions. Ethan's behavior suggests that he is successfully navigating an important developmental task within the developmental theory of:

Erikson

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She doesn't agree with the suggestion. Which response should the nurse prioritize when addressing this situation with the mother?

Erosion of the enamel on teeth: sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable and a pacifier will satisfy the sucking need, the most appropriate response is to warn of possible enamel erosion. Giving a bottle at bedtime is not a factor that leads to obesity. Pg 79

The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which of the following is accurate?

Explaining to the mother the risk for infection is high due to the lack of antibodies Explanation: Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. Abdominal breathing persists until 6 to 12 years of age. The respiratory system matures by age 7 years.

The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which of the following is accurate?

Explaining to the mother the risk for infection is high due to the lack of antibodies Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. Abdominal breathing persists until 6 to 12 years of age. The respiratory system matures by age 7 years.

What is the best awake state for infant interaction?

Eyes wide and bright The best time for a family to interact with an infant is when the infant is in the quiet or active alert stage. Examples of this are minimal body activity, regular respirations, face with shiny look, eyes wide and bright, and paying attention to stimuli.

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?

Facilitating return to school by working with the school nurse Much of an adolescent's life revolves around school and peers. In helping the teen return to school and friends, the nurse and the school nurse are achieving continuity of care and a supportive environment for healing. Teaching the mother cast care addresses the mother's learning needs and the teaching role of the nurse. Discussing driving safety with the teen is important and a factor in many adolescent injuries and deaths but is not a management activity. Changing dressings is a direct care activity of the nurse. pg 14

Following the discharge of a child who has a chronic health condition from the hospital, the nurse case manager follows up with a visit to the home and meets with the family and child. This visit best represents which philosophy of pediatric nursing?

Family-centered care The home visit by the case manager to some degree meets principles of each type of care, but is most representative of family-centered care because family-centered care is described as a mutually beneficial partnership between the child, the family, and health care professionals.

The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year-old will be best suited to work on which activity?

Form vases from blocks of clay

Many researchers have theories relating to the stages of growth and development. Which stage of accepted theories relates to the preschool-aged child from ages 4 to 6 years? Select all that apply.

Freud's phallic stage Erikson's stage of initiative vs. guilt Piaget's preoperational phase Kohlberg's re-conventional level stage 2

Which measure would you suggest an infant's parents use to relieve teething discomfort?

Give her a cold teething ring to chew.

Which measure would you suggest an infant's parents use to relieve teething discomfort?

Give her a cold teething ring to chew. Explanation: Cold can be very soothing for the tender gum lines during teething. A sedative is not necessary for normal teething discomfort.

Which measure would you suggest an infant's parents use to relieve teething discomfort?

Give her a cold teething ring to chew. -Cold can be very soothing for the tender gumlines during teething.

The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?

Grows and develops skills more rapidly than at any other time in their life

The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?

Grows and develops skills more rapidly than at any other time in their life.

The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?

Grows and develops skills more rapidly than at any other time in their life. Explanation: The infant grows and develops skills more rapidly than he or she ever will again. The toddler insists he or she can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours.

The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?

Grows and develops skills more rapidly than at any other time in their life: The infant grows and develops skills more rapidly than he or she ever will again. The toddler insists he or she can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours. Pg 64

A 2-month-old boy has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity.

A 2-month-old boy has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity. Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breastfeeding mom decrease her intake of gassy foods may alleviate the symptoms.

Mark is a 2-month-old that has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that Mark has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity. Explanation: Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breast-feeding mom decrease her intake of gassy foods may alleviate the symptoms.

A 2-month-old body has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity. -Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breastfeeding mom decrease her intake of gassy foods may alleviate the symptoms.

A 2-month-old boy has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?

He needs to try different formula to assess for sensitivity: Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breastfeeding mom decrease her intake of gassy foods may alleviate the symptoms. Pg 88

When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old?

He should speak in two-word sentences ("Me go").

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?

Head size has increased 5 in (12 cm) since birth. Explanation: The child's head size is large for his adjusted age of 4 months, which would be cause for concern. Normal growth would be 3.6 in (9 cm). At 10 lb, 2 oz (12 cm), the child is the right weight for a 4-month-old adjusted age. Palmar grasp reflex disappears between 4 and 6 months adjusted age, so this would not be a concern yet. The child is of average weight for a 4-month-old adjusted age.

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?

Head size has increased 5 in (12 cm) since birth: The child's head size is large for his adjusted age of 4 months-cause for concern. Normal growth would be 3.6 in. At 10 lb, 2 oz, the child is the right weight for a 4-month-old adjusted age. Palmar grasp reflex disappears between 4 and 6 months adjusted age, so this would not be a concern yet. The child is of average weight for a 4-month-old adjusted age. Pg 64

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which of the following findings is cause for concern?

Head size increased 5 inches since birth.

What is a current trend in child health care?

Health promotion rather than health restoration is stressed. It is recognized that keeping individuals well is more cost effective for a system than helping ill individuals return to wellness.

The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which findings are normal for this infant? Select all that apply.

Heart rate 101 beats per minute Blood pressure 100/50 Respiratory rate 28/minute Temperature 99 degrees Farenheit The respiratory rate slows from an average of 30 to 60 breaths in the newborn to about 20 to 30 in the 12-month-old. As the cardiovascular system matures, the average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year-old. Blood pressure steadily increases over the first 12 months of life, from an average of 60/40 in the newborn to 100/50 in the 12-month-old. Page 65

A toddler insists on brushing his own teeth and being left alone in the bathtub. What advice would you give his parents regarding this?

Helping with his own tooth brushing allows him to experience autonomy.

The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development?

Her vocabulary is between 10 and 15 words.

During a regular check up for a 24-month-old girl, the nurse observes that all incisors and cuspids and some first molars have erupted. This would be a good time to promote optimal oral care. Which of the following topics would be most appropriate?

Horizontal brushing technique

A nurse is teaching the parent of a 6-year-old with decay in several deciduous teeth about tooth care and the importance of seeing a dentist. What instruction is best for the nurse to inform the parent about the new 6-year molars?

If the 6-year molars become decayed and have to be pulled, the child could have dental problems later.

A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?

In two months you can try bananas if you think she is ready: The nurse should choose this response because no solid foods are recommended for infants until 3 months of age. The age of 4 to 6 months is the age recommended to introduce solid foods. The other responses are the incorrect age or are letting the parent decide the appropriate answer. Pg 86

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Increase in biting/sucking. Pg 89

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Increased biting and sucking

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? -Running a mild fever or vomiting -Choosing soft foods over hard foods -Increased biting and sucking -Frequent loose stools

Increased biting and sucking

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Increased biting and sucking Explanation: The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on.

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Increased biting and sucking -The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on.

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify what task as the task of the preschooler? a) Initiative b) Industry c) Autonomy d) Trust

Initiative Explanation: The developmental task of the preschool period is initiative versus guilt. Industry is the developmental task of the school-aged child. Trust is the developmental task of infancy. Autonomy is the developmental task of toddlerhood.

During a home visit, the nurse observes an 8-year-old child pick up toys and place them in the toy box. The child then looks to the mother who says, "Thank you for helping me." Which stage of Kohlberg's moral development is this child demonstrating?

Interpersonal relations of mutuality

A parent who is feeding his child formula prepared at home using evaporated milk is concerned about whether the child is receiving all necessary nutrients. What would it be important for this parent to add to his child's diet to supplement the formula?

Iron

Iron Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. Calcium and vitamin E would not be concerns in this infant's formula.

Iron -Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. Calcium and vitamin E would not be concerns in this infant's formula.

The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?

Iron: Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. Calcium and vitamin E would not be a concern in this infant's formula. pg 84

The infant in the exam room has the following signs and symptoms. Which ones will the nurse attribute to teething? Select all that apply.

Irritability and awakening from sleep

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which of the following recommendations is the most valuable advice?

Keep serving new foods several times

A nurse is providing teaching to a group of parents about safety in the home. The nurse determines that the teaching was successful when the group identifies which areas of the home as being the most hazardous? Select all that apply.

Kitchen, bathroom

What does Erikson describe as the psychosocial development task upon which other psychosocial development is built?

Learning to trust

Which of the following does Erikson describe as the psychosocial development task upon which other psychosocial development is built?

Learning to trust Explanation: Erikson's primary psychosocial developmental task for the infant is learning to trust. This task creates the foundation for the developmental tasks of the next stages of the child's life. If the infant does not receive food, love, attention, and comfort, the infant learns to mistrust the environment and those who are responsible for caring for the child.

Looking for a toy in her crib at the last place she saw it Explanation: Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant behaviors show use of her senses and motor activity but do not illustrate object permanence.

Looking for a toy in her crib at the last place she saw it Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant behaviors show use of her senses and motor activity but do not illustrate object permanence.

Looking for a toy in her crib at the last place she saw it. -Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it.

Looking for toy in crib at the last place she saw it: The infant knows the object still exists even though she cannot see it. All the rest of the infant's behaviors show use of her senses and motor activity but do not illustrate object permanence. Pg 72

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries?

Low birth weight Many factors may be associated with high infant mortality rates and poor health. Low birth weight and late or nonexistent prenatal care are the main factors in the poor rankings in infant mortality.

The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed?

Lower central gumline The lower central incisors are usually the first to appear, followed by the upper central incisors.

The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed?

Lower central gumline The lower central incisors are usually the first to appear, followed by the upper central incisors.

The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed?

Lower central gumline: The lower central incisors are usually the first to appear, followed by the upper central incisors. Pg 69

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively?

Maintain a feed-on-demand approach

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively?

Maintain a feed-on-demand approach Explanation: The best way to ensure effective feeding is by maintaining a feed-on-demand approach rather than a set schedule. Applying warm compresses to the breast helps engorgement. Encouraging the infant to latch on properly helps prevent sore nipples. Maintaining proper diet and fluid intake for the mother helps ensure an adequate milk supply.

The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity?

Medical records reveal a history of asthma Asthma is a morbidity factor for additional childhood illness, particularly respiratory illness. The child's height and weight are appropriate and not associated with increased risk. The normal WBC count may help to determine if the pneumonia is bacterial or viral. Being in a Boy Scout troop may increase the risk of exposure, but would not be as closely associated with morbidity as is asthma.

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved. When a nurse believes the physician has unduly coerced parents in their treatment decision, the nurse would be obliged to intervene and disclose any concerns. Such intentional or unintentional action would violate ethical principles of conduct. pg 18

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.

During an assessment, the nurse determines that a 3-month-old baby has a Moro reflex. What does this finding indicate to the nurse?

Most 3-month-olds still have a Moro reflex.

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex. Explanation: Typically, Moro (startle) reflexes last until 5 to 6 months and then fade.

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex. Typically, Moro (startle) reflexes last until 5 to 6 months and then fade.

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex: Typically, Moro (startle) reflexes last until 5 to 6 months and then fade. Pg 65

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal.

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal. Explanation: Many infants sit steadily by 8 months of age.

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal. Many infants sit steadily by 8 months of age.

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal: Many infants sit steadily by 8 months of age. p. 72.

The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability?

Most infants do not sit steadily until 8 months; this infant is normal. Explanation: At 3 months of age the infant should be able to raise the head about 45 degrees when in the prone position. The infant does yet have the developmental skills for sitting. Most infants are unable to sit steadily until 8 months of age. Gross motor skill development does not correlate with tooth eruption. The nurse should reassure the parent that this infant is on tract developmentally.

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth -Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months

assessment of 8-month-old infant. medical history notes show he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments?

Most likely present with developmental skills of a 6 month old: To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks or 2 months premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months. Pg 64

The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding?

Natal teeth noted in the mouth that are loose Explanation: The presense of 1 or 2 teeth at birth (natal teeth) is a finding that may be benign or may point to other congenital abnormalities. The neck should be short, thick and mobile. The gluteal folds should be symmetrical. It is normal for the newborn to startle to loud sounds.

Assessing the oral cavity of a 4 month infant. Which finding is consistent with a child of this age?

No teeth: the first primary teeth usually appear b/t 6 & 8 months. Pg 69

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?

Newborn A more accurate term for this child would be newborn rather than infant because the newborn or neonatal period of infancy is defined as the period from birth until 28 days of age. Infancy is the period of time up to 1 year old. Child and baby don't refer to the client's age accurately.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?

Newborn -A more accurate term for this child would be newborn rather than infant because the newborn or neonatal period of infancy is defined as the period from birth until 28 days of age. Infancy is the period of time up to 1 year old. Child and baby don't refer to the client's age accurately.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?

Newborn Explanation: A more accurate term for this child would be newborn rather than infant because the newborn or neonatal period of infancy is defined as the period from birth until 28 days of age. Infancy is the period of time up to 1 year old. Child and baby don't refer to the client's age accurately.

The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?

Newborn: A more accurate term for this child would be newborn rather than infant because the newborn or neonatal period of infancy is defined as the period from birth until 28 days of age. Infancy is the period of time up to 1 year old. Child and baby don't refer to the client's age accurately. Pg 64

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth Explanation: Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

A 17-year-old has been diagnosed with HIV. When developing the plan of care, which initial action should be included?

Notify the local health department of the individual's HIV status. The legal notification the local health department is mandated for certain communicable diseases. HIV is included in this category. Listing the sexual contacts and notifying them is the responsibility of the health authorities, not the individual clinic or office. Contacting the CDC will rest with the local health department.

While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated?

Object permanence

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention?

Observe the mother while she feeds and burps her infant.

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention?

Observe the mother while she feeds and burps her infant. Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is helpful information but not the priority.

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. Which of the following should be the priority nursing intervention?

Which milestone would you expect an infant to accomplish by 8 months of age? -Sitting without support -Creeping on all fours -Pulling self to a standing position -Being able to sit from a standing position

Sitting without support

The nurse is caring for a child who is scheduled to begin chemotherapy. When planning education for the parents what action by the nurse is most correct?

Obtain a small conference room and arrange the chairs in a circle for both the nurse and family members to sit. Teaching is an important function of the nurse. When providing the education, it is important to offer the information in an environment that is conducive to learning. A circular set of chairs will allow the nurse to face the parents during the exchange. A large class that has the nurse standing and the parents sitting does not provide the ability for a personal interaction needed for this session. Giving the parents information in writing should be done in conjunction with a face-to-face teaching session. Video information may be beneficial but does not replace the the face-to-face teaching session.

A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care?

Parents Parents and guardians have the primary responsibility for initiating and coordinating services rendered by health professionals. A social worker or case manager may be involved but are not primarily responsible for the child's care. The community provides programs to promote and support children's health. pg 17

While straightening the top drawer of a 10-year-old patient the nurse finds 48 packets of sugar. What should the nurse do at this time?

Place the sugar packets in the drawer as they were found.

What feeding practice used by the parents of an 8-month-old should the nurse discourage?

Placing all liquids given the child in a "no spill" sippy cup No spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times avoiding spills is essential. The other feeding practices are age appropriate and safe. Soft table and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.

What feeding practice used by the parents of an 8-month-old should the nurse discourage?

Placing all liquids given the child in a "no spill" sippy cup. No-spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times when avoiding spills is a must. The other feeding practices are age appropriate and safe. Soft table and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization. Page 86

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. Which of the following would have the most effect on the infant's neurologic development?

Promoting continuation of breastfeeding Explanation: Continuing to breastfeed ensures the proper level of nutritional fat for myelination of the nervous system. Having adequate dietary iron would help prevent anemia as the stores from fetal development are depleted. Promoting increased intake of solid foods is not necessary at 6 months and may diminish the amount of breast milk consumed. Fruit juice in the diet is not recommended. Fruits provide more nutrition and will soon be gradually added to the infant's diet.

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. Which of the following would have the most effect on the infant's neurologic development?

Promoting continuation of breastfeeding Continuing to breastfeed ensures the proper level of nutritional fat for myelination of the nervous system. Having adequate dietary iron would help prevent anemia as the stores from fetal development are depleted. Promoting increased intake of solid foods is not necessary at 6 months and may diminish the amount of breast milk consumed. Fruit juice in the diet is not recommended. Fruits provide more nutrition and will soon be gradually added to the infant's diet.

Which of the following milestones would you expect an infant to accomplish by 8 months of age?

Sitting without support Explanation: Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look?

Puts down a little ball to pick up a stuffed toy Explanation: At 6 months of age, the child is able to put down one toy to pick up another. He will be able to shift a toy to his left hand to reach for another with his right hand by 7 months. He will pick up an object with his thumb and finger tips at 8 months, and he will enjoy hitting a plastic bowl with a large spoon at 9 months.

The nurse is teaching the parents of a 6-month-old boy about proper child dental care. Which of the following actions will the nurse indicate as the most likely to cause dental caries?

Putting the child to bed with a bottle of milk or juice.

Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?

Reasoned with the child to stop the behavior

The nurse is reviewing documentation on a client's chart. The physician has referred to parens patriae. When considering this notation, what should be included in the client's plan of care?

Recognize the child's care has been ordered by the state. Generally the parents of a minor child have the right to make care decisions. In the event the parents have decided on a course of nontreatment, the state may intervene and overrule the parents. In this case an order for treatment to continue can be made by the courts. This is referred to as parens patriae (the state has a right and a duty to protect children).

The clinic nurse is assessing a 9-month-old client. The parents state, "Our baby is having a really hard time teething." Which nursing action is appropriate?

Recommend the parents provide the infant a cold teething ring to chew Chewing on a cold ring can be very soothing for the tender gumlines during teething. Warm foods offer no relief from teeting. Numbing agents are not recommended as they increase the risk of choking. Acetaminophen should not be administered routinely. It may be given every 4 to 6 hours as needed.

The nurse is focusing on health promotion for a 6-year-old girl. Which intervention best supports Healthy People goals?

Recommending a helmet for biking Recommending that the child wear a protective helmet best supports the goals of Healthy People because unintentional injury remains a leading cause of mortality and morbidity for children. Proper diet, adequate sleep, and after-school child care are important but do not affect child health status as much as injury prevention does.

The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth?

Remove high-calorie, low-nutrient foods from the diet.

The best way for an infant's father to help his baby complete the developmental tasks of the first year is to

Respond consistently: A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust. Pg 71

The best way for an infant's father to help his child complete the developmental task of the first year is to

Respond to her consistently. Explanation: A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust.

What should the nurse instruct a parent to help a child complete Erikson's developmental task during the infant period?

Respond to the child's needs consistently.

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat.

A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat.

A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat. The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falling off changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat. Explanation: The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falling off changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat. Explanation: The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falls from changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat: The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falls from changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings. Pg. 80

Risk for aspiration related to feeding the infant an inappropriate food

When describing play by the school-aged child to a group of nursing students, the instructor would emphasize the need for which of the following?

Rules

Which milestone would you expect an infant to accomplish by 8 months of age?

Sitting w/o support. P 72 Creep-9 months and pull to stand-10 months

Which milestone would you expect an infant to accomplish by 8 months of age?

Sitting without support

A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. Which of the following has the girl just demonstrated?

Secondary circular reaction Explanation: By the third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline.

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?

Serve new foods several times Explanation: When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns.

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?

Serve new foods several times When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns.

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?

Serve new foods several times -When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns

She has been a chatterbox and smiles just like her brother: The best time to feed an infant is when the child is in the active alert state. This infant is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put the infant in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with the child.Pg 65

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

Should have disappeared Explanation: This primitive (not protective) reflex should be present at birth and disappear around age 4 months.

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

Should have disappeared: This primitive (not protective) reflex should be present at birth and disappear around age 4 months. pg 67

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?

Showing the mother how to teach hand washing to her child. Teaching hand washing helps to prevent infection, emphasizes preventive care, and is basic to avoiding many common illnesses. Reminding the mother that the child will imitate her may promote safe parental role-modeling but does not reach the level of prevention that hand washing does. Knowing about developmental milestones and typical physical changes in toddlers does not directly promote preventive care.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting Independently: Infants typically sit independently, without support, by age 8 months. Walk independently-may be happen as late as age 15 months and still be in the normal range. Few infants walk independently by age 11 months. Building tower of 3-4 blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old. Pg 72

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? -Sitting independently -Walking independently -Building a tower of four cubes -Turning a doorknob

Sitting independently

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently Explanation: Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently -Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Which milestone would the nurse expect an infant to accomplish by 8 months of age?

Sitting without support Explanation: Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk.

Which milestone would you expect an infant to accomplish by 8 months of age?

Sitting without support -Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.

If the infant is following a normal pattern of dentition, the child would most likely have how many teeth by the age of 14 months?

Six to 12 teeth

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

Sleep in the room but not in an adult bed: According to the 2016 recommendation by the American Academy of Pediatrics, infants should sleep in the same bedroom as the parents, but on a separate firm surface, such as a crib or bassinet, and never on a couch, armchair or adult bed, to decrease the risks of sleep-related deaths. Pg 78

The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant?

Smiles at significant others

Lea is 3 months old. At what age would it be okay for Lea's mother to introduce carrots to her for dinner?

Solid food can be introduced at 4 to 6 months of age. Explanation: Solid food may be introduced at 4 to 6 months of age. The infant must be ready to handle spoon-feeding. The first food should be rice cereal. Rice cereal is bland and usually does not cause an allergic reaction.

At what age would it be okay to introduce carrots to an infant's diet?

Solid food can be introduced at 4 to 6 months of age. Solid food may be introduced at 4 to 6 months of age. The infant must be ready to handle spoon-feeding. The first food should be rice cereal. Rice cereal is bland and usually does not cause an allergic reaction.

At what age would it be okay to introduce carrots to an infant's diet?

Solid food can be introduced at 4 to 6 months of age: Solid food may be introduced at 4 to 6 months of age. The infant must be ready to handle spoon-feeding. The first food should be rice cereal. Rice cereal is bland and usually does not cause an allergic reaction. Pg 85

The nurse is assessing the development of a 15-month-old girl during a well-child visit. Which skill would the nurse expect to see?

Stands alone

The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior?

Starting intravenous fluids even though the child protests Ignoring the child's dissent regarding proposed therapy is ethically sound. The treatment will benefit the child, and at 5 years of age the decision maker is nearly always the parent or legal guardian. However, the nurse must use developmentally appropriate techniques to inform the child about the therapy and to carry it out. Telling her an intramuscular injection won't hurt lacks veracity. Referring to the girl as "her" when she is present shows disrespect. Scheduling a laboratory procedure at lunchtime is unfair to the child and lacks justice.

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures.

Step Root Moro Plantar Babinski Page 71

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures. Moro, Step, Babinski, Root and Plantar

Step Root Moro Plantar Babinski

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures.

Step Root Moro Plantar Babinski

The nurse is assessing an infant who is being breast-fed. Which observation regarding the infant's stools is expected?

Stool will be soft.

Put the following developmental milestones related to an infant's hearing in correct chronological order:

Stop activity in response to spoken word Turn head to locate sound Locate sounds downward and to side Locate sounds made above Recognize name when spoken Locate & turn toward sound in any direction

A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing:

Stranger anxiety Explanation: Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development.

Stranger anxiety Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development.

The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly?

Telling the child firmly that we don't scream in the office

The 18-month-old has most likely attained which gross motor skill?

The ability to walk independently.

The nurse is assessing an infant at his 4-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg)and was 20 in (50.8 cm)in length. Which finding is most consistent with the normal infant growth and development?

The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length. -The average infant's weight doubles at 4 months and will triple at 1 year of life. The infant's length will increase by 50% by the first year.

The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg) and was 20 in (50.8 cm) in length. Which finding is most consistent with the normal infant growth and development?

The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length.: The average infant's weight doubles at 6 months and will triple at 1 year of life. The infant's length will increase by 50% by the first year. pg 64

The nurse is assessing an infant at his 6 month well baby check-up. The nurse notes that at birth the baby weighted 8 pounds and was 20 inches in length. Which of the following findings is most consistent with the normal infant growth and development?

The baby weighs 16 pounds and is 26 inches in length.

In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching?

The child hides behind her bedroom door when defecating.

The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?

The child is unable to push a toy lawnmower.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age.

The nurse is advised in the change of shift report that a child on the unit is considered a "mature minor". What criteria must this child meet to be considered in this role?

The child must have the maturity to understand the information provided related to his condition and planned course of treatment. In some states, a mature minor may give consent to certain medical treatment. The physician must determine that the adolescent (usually older than 14 years of age) is sufficiently mature and intelligent to make the decision for treatment. The provider also considers the complexity of the treatment, its risks and benefits, and whether the treatment is necessary or elective before obtaining consent from a mature minor.

Which behavior best demonstrates an example of Erikson's developmental task for the school age child?

The child spends a rainy day putting together a puzzle of a large jungle animal.

The nurse caring for a hospitalized 8-year-old child recognizes that the child has developed an understanding of reversibility. Which of the following relates to the development of this understanding?

The child understands that his or her illness is probably only temporary.

A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns?

The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron.

The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?

The importance of crossing streets safely Motor-vehicle accidents are a leading cause of death in this age group. p 10

What action shows an example of Erik Erikson's developmental task for the infant?

The infant cries and the caregiver picks the child up.

What action shows an example of Erik Erikson's developmental task for the infant?

The infant cries and the caregiver picks the child up. Erikson's psychosocial developmental task for the infant is to develop a sense of trust. The development of trust occurs when the infant has a need and that need is met consistently.

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex)

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex).

The nurse is conducting a physical examination of a 5-month-old boy. Which of the following observations may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex). Explanation: The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age.

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex). The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age.

The nurse is conducting a physical examination of a 5-month-old boy. Which of the following observations may be cause for concern about the infant's neurologic development?

The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex): The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex(fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. Anterior fontanel, which remains open for brain growth, closes between 12 & 18 months of age. Pg72

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.

The infant does not pay attention to noises behind him. The infant has frequent episodes of crossed eyes. The infant seems disinterested in the surrounding environment. Warning signs that may indicate problems with sensory development include the following: young infant does not respond to loud noises; child does not focus on a near object; infant does not start to make sounds or babble by 4 months of age; infant does not turn to locate sound at age 4 months; infant crosses eyes most of the time at age 6 months. Language development at this stage of development does not include stringing together 2-word sentences. Page 74

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.

The infant does not pay attention to noises behind him. The infant has frequent episodes of crossed eyes. The infant seems disinterested in the surrounding environment. Explanation: Warning signs that may indicate problems with sensory development include the following: young infant does not respond to loud noises; child does not focus on a near object; infant does not start to make sounds or babble by 4 months of age; infant does not turn to locate sound at age 4 months; infant crosses eyes most of the time at age 6 months. Language development at this stage of development does not include stringing together 2-word sentences.

The nurse is assessing the oral cavity of a 4-month-old infant. Which of the following findings are consistent with a child of this age?

The infant has no teeth

A 2-month-old infant has inconsolable crying, is gassy, and constantly draws the legs up. It has been determined that the infant has colic. What intervention should the nurse recommend to treat colic?

The infant is bottle fed, so the parent needs to try a different formula to assess for sensitivity. Explanation: Colic is defined as inconsolable crying that lasts at least 3 hours or longer per day. Colic can begin as early as 2 weeks and usually resolves itself by 3 months. Parents should take a stepwise approach to resolving colic. The first step is to make sure all the infant's needs are met. Then decrease any stimuli, use soothing techniques such as carrying the infant, swaddling, pacifiers, etc. If the inafnt is formula fed, it may be necessary to see if changing to sensitive formula would help. The breastfeeding mother should not be eating any gas producing foods and should limit the amount of caffeine intake to see if diet plays a role in producing colic.

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which of the following observations needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near. Explanation: If the infant does not respond to his mother's voice, it could indicate a hearing loss. Infants recognize parents' voices from 1 month of age. It is normal for the infant to turn his head in the direction of a squeak toy, to focus visually on near or high-contrast objects, and to make babbling sounds but no words by this age. Infants develop a social smile at 2 months.

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which observation needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near. -If the infant does not respond to his mother's voice, it could indicate hearing loss. Infants recognize parents' voices from 1 month of age

The infant says "da-da" when looking at her father

The infant says "da-da" when looking at her father By 9 months, an infant usually speaks a first word: "da-da" or "ba-ba." The other answers refer to earlier milestones in language development. In response to a nodding, smiling face, or a friendly tone of voice, a 3-month-old infant will squeal with pleasure or laugh out loud. By 4 months, infants are very "talkative," cooing, babbling, and gurgling when spoken to. At 6 months, infants learn the art of imitating. They may imitate a parent's cough, for example, or say "Oh!" as a way of attracting attention.

The infant says da-da when looking at her dad: By 9 months, an infant usually speaks a first word: "da-da" or "ba-ba." The other answers refer to earlier milestones in language development. In response to a nodding, smiling face, or a friendly tone of voice, a 3-month-old infant will squeal with pleasure or laugh out loud. By 4 months, infants are very "talkative," cooing, babbling, and gurgling when spoken to. At 6 months, infants learn the art of imitating. They may imitate a parent's cough, for example, or say "Oh!" as a way of attracting attention. pg18

The nurse is reviewing topics to be discussed with caregivers related to caring for infants. Which statement would be the most appropriate statement for the nurse to make to this group of caregivers?

The infant sleeps 10-12 hours at night and take 2-3 naps during the day Most infants sleep 10-12 hours at night and take 2-3 naps. By being put to bed while awake and allowed to fall asleep, the infant learns good sleeping habits. The infant should be dressed in the same amount of clothing the adult finds comfortable. Hard-soled shoes are not needed by infants and may hamper the development of the foot.

Using knowledge of normal growth and development, what would be expected when observing a 12-week-old infant?

The infant smiles at significant others By 12 weeks of age the infant smiles at his mother and significant others. The other choices are seen in the infant who is about 20 weeks of age. Page 77

The nurse is assessing the neurological status of a 10-month-old infant. Which findings does the nurse determine to be abnormal when performing this assessment?

The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked/ The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth/The infant reflexively grasps when the nurse touches the palm/With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C": The primitive reflexes (root, suck, palmar grasp, moro) should be absent by 10 months of age. The Babinski reflex persists until 12 months of age so the presence of this reflex would be considered a normal finding in the 10-month-old. pg 65

The infant will most likely present with developmental skills consistent with a 6-month-old infant.

The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?

The need for separation and control

The student nurse is reviewing the chart of a newborn. The document indicates the newborn is in the quiet alert state. Which is the best description of this sleep phase?

The newborn's eyes are open and no body movements are noted. The normal newborn moves through 6 stages of consciousness. The quite alert state is when the infant's eyes are open but the body is calm. Open eyes accompanied by body movements is characteristic of the active alert state. Page 65

The student nurse is reviewing the chart of a newborn. The document indicates the newborn is in the quiet alert state. Which is the best description of this sleep phase?

The newborn's eyes are open and no body movements are noted: The normal newborn moves through 6 stages of consciousness. The quite alert state is when the infant's eyes are open but the body is calm. Open eyes accompanied by body movements is characteristic of the active alert state. Pg 65

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:

The newborn's stomach can hold between one-half and 1 ounce: The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1.5 to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night. pg 69

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother:

The newborn's stomach can hold between one-half to 1 ounce. Explanation: The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1½ to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.

An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated?

The next visit would be at 6 months.

An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated?

The next visit would be at 6 months. The routine schedule for newborn visits within the first year of life is at 1 week, and then at 1, 2, 4, 6, 9, and 12 months of age. The above infant should be seen at 6 months of age for follow-up care and instructions.

According to the pediatric patient's Bill of Rights, the nurse manager should privately counsel a staff nurse to change their behavior in which of these situations? Select all that apply.

The nurse manager hears the staff nurse call the patient "kiddo." The nurse manager hears the parents ask the name of the surgeon that has been consulted and the staff nurse responding, "I'm not sure, it's best if you ask your doctor." A patient's Bill of Rights helps to ensure that the patient's needs are being met in an ethical and legal manner. The staff nurse calling the child "kiddo" and not informing the parents of a child the name of the care provider consulted violates the bill of rights, requiring counseling my the nurse manager.

The quality assurance nurse in a hospital is evaluating the care provided on a pediatric surgical unit. When evaluating if the nurses on the unit are using best evidence-based practice guidelines, the nurse questions which actions by the nursing staff on the pediatric surgical unit? Select all that apply

The nurse performs hand hygiene using alcohol-based hand gel before and after performing a physical assessment on a child. The nurse performs hand hygiene using soap and water prior to charting in the electronic medical record. The nurse takes the child to the sink to perform hand hygiene using soap and water prior to the child eating lunch. The nurse teaches the family to perform hand hygiene before and after changing their child's surgical dressing at home. The nurse asks the family to perform hand hygiene prior to entering the room of the child receiving chemotherapy for cancer treatment. Based on evidence-based practice guidelines for infection control, the nurse demonstrates evidence-based practice interventions in each scenario.

The nurse is working in a pediatric facility whose mission statement strongly emphasizes providing family-centered care. What nursing intervention best exemplifies this facility's belief?

The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child Providing care with an emphasis on a family-centered approach leads to better client outcomes as well as satisfaction with the facility and staff in care provided. Family-centered care involves a mutually beneficial partnership between the child, the family, and health care professionals.

A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?

The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen.

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?

The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?

The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog Providing a safe environment, redirection away from undesirable behaviors, and saying "no" in appropriate instances are effective forms of discipline for an infant's developmental level. Infants are at an increased risk for injury from spanking and do not understand the reason for the spanking. Infants do not understand time-outs or the reason for this type of discipline.

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?

The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog Explanation: Providing a safe environment, redirection away from undesirable behaviors, and saying "no" in appropriate instances are effective forms of discipline for an infant's developmental level. Infants are at an increased risk for injury from spanking and do not understand the reason for the spanking. Infants do not understand time-outs or the reason for this type of discipline.

The parents of a 9-year-old agree to allow their child to participate in a research project involving drug trials for a new drug for attention deficit hyperactivity disorder. Which rights of the child are related to beneficence? Select all that apply.

The parents and child are told of the physical and nonphysical risks associated with the research. The parents and child are informed of the possible adverse effects of the research. The parents and child are told of the direct and indirect benefits of participation. For issues related to beneficence, the parents and child should know the risks, adverse effects, and expected benefits of the research. Being fully informed of strategies to safeguard identity is an issue of confidentiality. Knowing they can withdraw at any time is a right of refusal, and knowing whom to contact for information is a basic right.

The nurse is assessing the neurological status of a 10-month-old infant. Which findings does the nurse determine to be abnormal when performing this assessment? Select all that apply. -The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked -The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth -The infant reflexively grasps when the nurse touches the palm -The infant fans and extends the toes when the nurse strokes along the lateral aspect of the sole and across the plantar surface of the foot -With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C"

The primitive reflexes (root, suck, palmar grasp, moro) should be absent by 10 months of age. The Babinski reflex persists until 12 months of age so the presence of this reflex would be considered a normal finding in the 10-month-old.

A 1-month-old infant's mother voices concern about her baby's respirations. She states they are rapid and irregular. What information should be provided by the nurse?

The respirations of a 1-month old infant are normally irregular and periodically pause.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? -The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. -The respirations of a 1-month-old infant are normally irregular and periodically pause. -An infant at this age should have regular respirations. -The irregularity of the infant's respirations are concerning; I will notify the physician.

The respirations of a 1-month-old infant are normally irregular and periodically pause.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause. Explanation: The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause. The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause. -The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause: The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm. Pg 65

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which of the following parent comments might reveal a cause of the night waking?

They put her to bed when she falls asleep.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep. Explanation: If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep. If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? -They sing to her before she goes to sleep. -They put her to bed when she falls asleep. -If she is safe, they lie her down and leave. -The child has a regular, scheduled bedtime.

They put her to bed when she falls asleep. (If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her)

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep. -If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep: If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices. Pg 87

During a home visit, the nurse observes a 9-month-old child bang his head against the headboard of the crib at naptime. What should the nurse explain to the mother about this observation?

This action is normal up until preschool age.

A toddler's father is concerned because his son refuses to share. What is your best response concerning this?

This is normal toddler behavior; sharing is learned later.

The nurse providing care to the fifth-grade child and his family reviews the nursing care plan, noting that teaching about pubertal changes is one of the individualized interventions. The nurse chooses not to address this. How should the nurse's action be evaluated?

This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice. The nurse is not meeting professional role expectations. Implementing the interventions identified in the plan of care is expected. Nurses include families in developing the care plan. This is part of family-centered care. Nurses make clinical decisions but would omit teaching only if data indicated it a wise choice. Sexuality education falls to the school, family, and nurse. pg 14

T/F: The best way for a parent to handle a temper tantrum by a toddler is to calmly express disapproval and then ignore it.

True

T/F: When leaving a child who has separation anxiety, parents should say goodbye firmly, explain that they will return, and then leave promptly.

True

To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks or 2 months premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months.

What was the primary goal for the establishment of the Children's Bureau?

To improve the standards of health care he establishment of the Children's Bureau in 1912 began a period of studying economic and social factors related to infant mortality, infant care in rural areas, and other factors related to children's health. The goal of these legislative efforts was to improve the standards of health care.

A first-time mother calls the pediatrician's office to ask the nurse about her baby's tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby's dentition?

Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption.

A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

Total weight gain of 15 lb in the past year

Sonograms demonstrate thumb sucking as early as in utero.

True Pg 89

The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life?

Trust

Which developmental task, according to Erikson, should an infant accomplish during the infant year?

Trust The developmental task of the infant year, according to Erikson, is to gain a sense of trust or knowing how to love.

Trust Explanation: Erikson identifies various developmental stages which all children accomplish as they grow and develop into adults. The primary psychosocial developmental task for the infant is learning to trust. This task creates the foundation for the developmental tasks of the next stages of the child's life. If the infant does not receive food, love, attention, and comfort, the infant learns to mistrust the environment and those who are responsible for caring for the child. Learning to feel anger, love, and fear come at later times in development.

The nursing instructor is conducting a class discussion exploring the normal dentition progression of the school-aged child. The instructor determines the session is successful when the students correctly choose which factor as most likely occurring in 10-year-olds?

Two of the cuspid teeth have erupted.

The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1?

Understands "no" and other simple commands

The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1?

Understands "no" and other simple commands At age 1, most babies understand the word "no" and other simple commands. Children at this age also learn one or two other words. Babies squeal, make pleasure sounds, and use multisyllabic babbling at age 6 months. Using speech-like rhythm when talking with an adult usually occurs between ages 9 to 12 months.

The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1?

Understands no and other simple commands: At age 1, most babies understand the word "no" and other simple commands. Children at this age also learn one or two other words. Babies squeal, make pleasure sounds, and use multisyllabic babbling at age 6 months. Using speech-like rhythm when talking with an adult usually occurs between ages 9 to 12 months. pg 76

The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?

Undressing himself

Urging the baby's mother to take time for herself away from the child

Urging the baby's mother to take time for herself away from the child Explanation: Urging the parents to get time away from the child would be most helpful in the short term, particularly if the parents are stressed. Educating the parents about when colic stops would help them see an end to the stress. Observing how the parents respond to the child helps to determine if the parent/ child relationship was altered. Assessing the parents' care and feeding skills may identify other causes for the crying.

Urging the baby's mother to take time for herself away from the child Urging the parents to get time away from the child would be most helpful in the short term, particularly if the parents are stressed. Educating the parents about when colic stops would help them see an end to the stress. Observing how the parents respond to the child helps to determine if the parent/ child relationship was altered. Assessing the parents' care and feeding skills may identify other causes for the crying.

The nurse is caring for the family of a 2-month-old baby with colic. The mother reports feeling very stressed by the baby's constant crying. Which of the following interventions would provide the most help in the short term?

Urging the baby's mother to take time for herself away from the child.

A new mother is concerned about the risk of her 6-month-old aspirating and choking. Which of the following should the nurse recommend to her? Select all that apply.

Use only clothing without decorative buttons Don't prop up the baby's bottle when feeding him

Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which technique would the nurse most likely suggest?

Use short "time-outs" and remain calm.

A new mother complains that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. Which of the following would be most helpful for this mother to do to encourage healthy sleeping patterns? The mother should

Use the crib for sleeping only, not for play activities Explanation: A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.

Use the crib for sleeping only, not for play activities.

Use the crib for sleeping only, not for play activities. A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk?

Uses only the left hand to grasp

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk?

Uses only the left hand to grasp Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which of the following observations points to a developmental risk?

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk?

Uses only the left hand to grasp: Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks. pg 72

The mother of a 1-week-old baby boy voices concerns about her baby's weight loss since birth. At birth the baby weighted 7 pounds; the baby currently weights 6 pounds 1 ounce. What response by the nurse is most appropriate?

Your baby has lost a bit ore than the normal amount.

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?

Uses two-word sentences or phrases

The client is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program would you recommend to the child's young mother?

WIC The special supplemental nutrition program for women, infants, and children (WIC) provides services to supply nutritional food to low-income women and their children. SCHIP or CHIP provides health insurance to newborns and children in low-income families who do not otherwise qualify for Medicaid and are uninsured. The Early Childhood Intervention (ECI) program, sponsored by Easter Seals, is available for the child with disabilities or developmental delays. pg 8

The nurse provides soy milk and fresh vegetables to a pregnant woman who is single, and the mother of a toddler. Which federal program is the nurse implementing?

WIC Food Package Revised WIC Food Package Revised was designed to improve nutritional intake of the original WIC program (1966/1974) by supporting and promoting long-term breastfeeding and adding fruits and vegetables, whole grains, soy-based foods and a variety of culturally appropriate foods to recipients. In 1921 the Maternity & Infancy (Sheppard-Towner) Act provided grants to states to establish maternal and child health divisions in state health departments. Expansion of Lunch & Nutrition Act provides food for low income school age children year round along with low income children in daycare and Head Start programs. The No Child Left Behind Act of 2002 was enacted to ensure that all children in all classrooms have a research-based curriculum, well-prepared teachers, and a safe learning environment.

During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group?

We keep a strict bedtime ritual for our son, which includes a bath and bedtime story."

Which nursing activity requires the pediatric nurse to implement the ethical principle of nonmaleficence?

Weighing the potential harm caused by a child's chemotherapy with its potential benefits Questions of risks versus benefits often require the care team to examine options in the light of nonmaleficence; that is, the responsibility to avoid undue harm. Encouraging an adolescent to take ownership of her health will likely involve the principle of autonomy. Mediating in a family dispute or providing empathic care is less likely to involve the principle of nonmaleficence. pg 16

When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

The nurse is assessing all of the factors which contribute to the growth and development of a 5-year-old child. Which factor contributes least to the ultimate height that a child reaches?

Whether he enjoys active sports or not.

The nurse checks on a new mother to see how breast-feeding is going with her new son. The nurse observes infant is on the mother's lap with the blanket unwrapped, the mother is washing his face, and gently stroking the baby. The mother had trouble breastfeeding the last few times. What is the appropriate response from the nurse?

You are doing a good job trying to wake the baby: The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment. Page 82

You may be right since infants can sense their mother's smell as early as 7 days old: The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell. Pg74

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth: At the time of birth an infant's stomach can only hold 1/2 to 1 ounce. This will gradually increase. While it is true that the infant does not eat much this does not meet the educational needs of the mother and is not the best response. Burping is a part of normal newborn feeding practices but is not the best response. There is no indication there is a milk intolerance from the information reported. Pg 69

A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend?

a rear-facing 5-point harness restraint

The nurse is teaching a first-time mother with a 14-month-old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother? a) "Never let him out of your sight when outdoors." b) "Place a gate at the top of each stairway." c) "Put chemicals in a locked cabinet." d) "Don't smoke in the house or car."

a) "Never let him out of your sight when outdoors." Explanation: Because they are curious and mobile, toddlers require direct observation and cannot be trusted to be left alone, especially when outdoors. The priority guidance is to never let the child be out of sight. Gating stairways, locking up chemicals, and not smoking around the child are excellent, but specific, safety interventions.

The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply. a)Around 2 months the infant exhibits a first real smile. b)Separation anxiety may also start in the last few months of infancy. c) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. d)Around 5 months the infant may develop stranger anxiety. e)Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. f)Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo.

a) Around 2 months the infant exhibits a first real smile. b) Separation anxiety may also start in the last few months of infancy. c) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. e) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. Explanation: The infant exhibits a first real smile at age 2 months. By about 3 months of age the infant will start an interaction with a caregiver by smiling widely and possibly gurgling. The 3- to 4-month-old will also mimic the parent's facial movements, such as widening the eyes and sticking out the tongue. Separation anxiety may also start in the last few months of infancy. Around the age of 8 months the infant may develop stranger anxiety. At 6 to 8 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo.

The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which statements accurately describe the typical infant's achievement of these milestones? Select all that apply. a)At 7 months the infant sits alone with some use of hands for support. b)At 1 month the infant lifts and turns the head to the side in the prone position. c)At 2 months the infant rolls from supine to prone to back again. d)At 12 months the infant walks independently. e)At 9 months the infant crawls with the abdomen off the floor. f)At 6 months the infant pulls to stand up.

a) At 7 months the infant sits alone with some use of hands for support. b) At 1 month the infant lifts and turns the head to the side in the prone position. d) At 12 months the infant walks independently. e) At 9 months the infant crawls with the abdomen off the floor. Explanation: At 1 month the infant lifts and turns the head to the side in the prone position. At 7 months the infant sits alone with some use of hands for support. At 9 months the infant crawls with the abdomen off the floor. At 12 months the infant walks independently. At 4 months the infant lifts the head and looks around. At 10 months the infant pulls to stand up.

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply. a)Books and stories can help preschoolers master proper behavior. b)A time-out of about 8 minutes would be appropriate for intentional misbehavior. c)Spank with an open hand only and never with an object. d)Anticipate situations likely to cause misbehavior and redirect the child to another activity. e)When discussing improper behavior, call the behavior "bad" or "naughty," not the child.

a) Books and stories can help preschoolers master proper behavior. d) Anticipate situations likely to cause misbehavior and redirect the child to another activity. e) When discussing improper behavior, call the behavior "bad" or "naughty," not the child. Explanation: Spanking is the least effective discipline and discouraged by pediatric professionals. If chosen by parents, it should be infrequent and done only with an open hand. Labeling behavior and not the child supports self-esteem. One minute per year of age is an appropriate length for time-outs. Redirecting from events that tend to lead to misbehavior is wise and reduces conflict. Preschoolers can learn much from stories and books including appropriate behavior.

The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. a) Initiates activities with others b) Engages in parallel play with peers c) Plans activities and makes up games d) Acts out roles of other people e) Classifies or groups objects by their common elements f) Understands relationships among objects

a) Initiates activities with others c) Plans activities and makes up games d) Acts out roles of other people Explanation: The many activities of the preschooler include beginning to plan activities, making up games, initiating activities with others, and acting out the roles of other people (real and imaginary). Toddlers engage in parallel play; preschoolers engage in cooperative play. School-age children classify or group objects by common elements and understand relationships among objects.

Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds a) Johnny's height and weight should be plotted on a growth chart. b) Johnny is growing slowly in height but rapidly in weight. c) Johnny is following a normal pattern of growth for the preschool years. d) Johnny may be at risk for overweight or obesity.

a) Johnny's height and weight should be plotted on a growth chart. b) Johnny is growing slowly in height but rapidly in weight. d) Johnny may be at risk for overweight or obesity. Explanation: The preschool child's growth is fairly even. The child should grow about 2½ to 3 inches and gain around 5 pounds yearly. Johnny is not following this pattern. Plotting the child's height and weight on a growth chart would make it visually easy to follow his growth pattern and compare it to the norms.

The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important? a) Never spank the child for any reason. b) Rules and limits should be simple and few c) Use praise when the child is doing something right. d) Toddlers are unable to learn rules easily.

a) Never spank the child for any reason. Explanation: Toddlers younger than 18 months of age should not be spanked due to the possibility of injury. All the other statements describe toddler characteristics accurately and are basic to good discipline but are not the most important for this young toddler.

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? a) Puts down a little ball to pick up a stuffed toy b) Enjoys hitting a plastic bowl with a large spoon c) Shifts a toy to his left hand and reaches for another d) Picks up an object using his thumb and finger tips

a) Puts down a little ball to pick up a stuffed toy Explanation: At 6 months of age, the child is able to put down one toy to pick up another. He will be able to shift a toy to his left hand to reach for another with his right hand by 7 months. He will pick up an object with his thumb and fingertips at 8 months, and he will enjoy hitting a plastic bowl with a large spoon at 9 months.

A mother brings her 4-year-old son in for a check-up. Which of the following findings should the nurse be concerned about? a) Resting pulse rate of 120 b) Ectomorphic body type c) Weight gain of 5 lb in the past year d) No increase in appetite compared with that in toddler years

a) Resting pulse rate of 120 Explanation: Pulse rate in preschool children decreases to about 85 bpm typically, so the nurse should be concerned about a pulse rate of 120 in a 4-year-old. Contour changes in preschool children are so definite that future body type—ectomorphic (slim body build) or endomorphic (large body build)—becomes apparent. Neither of these body types is a reason for concern. During these years, appetite remains the same as it was during the toddler years, a level perhaps considerably less than some parents would like or expect. Weight gain is slight during the preschool years as the average child gains only about 4.5 lb (2 kg) a year. (less)

The nurse is assessing the development of a 15-month-old girl during a well-child visit. Which skill would the nurse expect to see? a) Stands alone b) Runs to her mother c) Points to her nose and mouth d) Feeds herself with a spoon

a) Stands alone Explanation: At 15 months, toddlers have mastered standing and walking alone. The child has yet to develop the ability to feed herself with a spoon, point to her nose and mouth, or run to her mother.

Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium? a) White beans b) Spinach c) Fortified cereal d) Enriched bread

a) White beans Explanation: To ensure an adequate intake of calcium, the nurse should suggest white beans, because 1 ounce of dried white beans when cooked provides 160 mg of calcium. Spinach, enriched bread, and fortified cereal are good sources of iron.

A toddler's parents want to begin toilet training him. As a rule, the best instruction you could give them is: a) bowel training is easier than urine training. b) all children should be toilet trained by age 2 years. c) toilet training is a 12-month process. d) children can remain dry during the night before they can do so during the day.

a) bowel training is easier than urine training. Explanation: Bowel training is often easier than urine training because the substance to be evacuated is so much more tangible.

The best way for parents to aid a toddler in achieving his developmental task would be to:

allow him to make simple decisions.

The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response?

as soon as the first tooth erupts Explanation: Before tooth eruption occurs, parents should clean the infant's gums after feeding with a damp wash cloth. After the first tooth erupts, parents can use a soft bristle tooth brush. Dental hygiene should be part of the infant's everyday care. The American and Canadian Dental Associations recommend the first dental checkup to occur around 1 year of age. Infants should not go to bed with bottles or sippy cups to prevent dental caries.

The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:

as soon as the first tooth erupts.

The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:

as soon as the first tooth erupts. Toothbrushing should begin with the eruption of the first tooth.

The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations? a) "Respond in a calm but firm manner." b) "You need to adhere to various routines." c) "Put her in time-out when she misbehaves." d) "It's important to toddler-proof your home."

b) "You need to adhere to various routines." Explanation: Making expectations known through everyday routines helps to avoid confrontations. This helps the child know what to expect and how to behave. It is the best guidance to give these parents. Calm response and time-out are effective ways to discipline, but do not help to prevent confrontations. Toddler-proofing the house doesn't eliminate all the opportunities for confrontation.

When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about a) 16 pounds and grown 4-6 inches. b) 8 pounds and grown 4-6 inches. c) 8 pounds and grown 2-3 inches. d) 16 pounds and grown 2-3 inches.

b) 8 pounds and grown 4-6 inches. Explanation: During the first 6 months, an infant's birth weight doubles and his or her height increases by about 6 inches. Growth slows slightly during the second 6 months but is still rapid. By 1 year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage? a) Giving the child opportunity to speak and finish her ideas b) Asking the girl to slow down and to think before she talks c) Looking at the child while she is speaking d) Enunciating clearly and slowing down parental speech

b) Asking the girl to slow down and to think before she talks Explanation: Many preschoolers stutter as thinking races ahead of their ability to articulate ideas. Most of this stuttering, when not made an issue, will resolve on its own. Calling attention to the dysfluency often exacerbates it. All the other practices are helpful.

The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erickson's theory of development, what would be an appropriate intervention for this child? a) Encourage the child to take turns when playing games. b) Encourage the child to pick out his own clothes. c) Use "time-outs" whenever the child says "no" inappropriately. d) Discourage solitary play; encourage playing with other children.

b) Encourage the child to pick out his own clothes. Explanation: Erikson defines the toddler period as a time of autonomy versus shame and doubt. It is a time of exerting independence. Allowing the child to choose his own clothes helps him to assert his independence. Negativism—always saying "no"—is a normal part of healthy development and is occurring as a result of the toddler's attempt to assert his or her independence. It should not be punished with "time-outs." The toddler should be encouraged to play alone and with other children. Toddlers cannot take turns in games until age 3.

A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? a) Solitary play b) Imitative play c) Parallel play d) Group play

b) Imitative play Explanation: Preschoolers enjoy games that use imitation such as pretending to be teachers, cowboys, firefighters, and store clerks. They imitate exactly what they see their parents doing. Parallel play is characteristic of toddlers. Preschoolers are capable of sharing and play with other children as a means for socialization. Older preschoolers are interested in group games.

The nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform? a) Winding up a mechanical toy b) Knowing which are his or her toys c) Completing puzzles with four pieces d) Playing make-believe with dolls

b) Knowing which are his or her toys Explanation: The toddler in Piaget's sensorimotor stage of cognitive development (18 to 24 months) understands requests, is capable of following simple directions, and has a sense of ownership (knowing which toys are his). The other tasks are accomplished by the child in the preoperational stage (2 to 7 years).

The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply. a) Avocados b) Spinach c) Broccoli d) Carrots e) Applesauce f) Sweet potatoes

b) Spinach e) Carrots f) Sweet potatoes Explanation: Foods that are high in vitamin A include apricots, cantaloupe, carrots, mangos, spinach and dark greens, and sweet potatoes. Applesauce is high in fiber, and avocados and broccoli are high in folate.

The nurse is teaching the mother of a 2-year-old boy about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child? a) Giving the child a toy vacuum cleaner b) Providing a brightly colored plastic bucket and shovel c) Giving the child bowls, pot, pans, and large spoons d) Offering the child a variety of large stuffed toys

c) Giving the child bowls, pot, pans, and large spoons Explanation: The kitchen items are usually of most interest since they give opportunity to copy observed parental actions. Also, these items can be used not only to role model but also to stack, nest, make noise, and rearrange in many configurations. They are also inexpensive. However, all the other toys are appropriate and safe for toddlers.

The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. a) The trachea and chest wall are less compliant. b) The nasal passages are narrower. c) The tongue is smaller. d) There are significantly fewer alveoli. e) The larynx is more funnel shaped. f) The bronchi and bronchioles are shorter and wider.

b) The nasal passages are narrower. d) There are significantly fewer alveoli. e) The larynx is more funnel shaped. Explanation: In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel shaped, the tongue is larger, and there are significantly fewer alveoli. These anatomic differences place the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels of maturity until about 7 years of age.

The nurse is assessing speech development in the 2-year-old whose family uses both Spanish and English in the home. What finding is of concern? a)The parents understand the child much of the time. b)The toddler speaks 15 words between the two languages. c)The child mixes words from the two languages within a sentence. d)Some words the toddler speaks are a blend of English and Spanish.

b) The toddler speaks 15 words between the two languages. Explanation: Of concern is speaking only 15 words between Spanish and English. At 20 months, the bilingual child should use 20 words. The other findings fit the norms for a bilingual child.

The nurse is discussing the activities of a 20-month-old child with his mother. The mother reports the children of her friends seem to have more advanced speech abilities than her child. After assessing the child, which finding is cause for follow up? a) Points to pictures in books when asked b) Understands approximately 200 words c) Inability to point to named body parts d) Inability to talk with the nurse about something that happened a few days ago

b) Understands approximately 200 words Explanation: The 20-month-old toddler should have a vocabulary greater than 40 to 50 words and should comprehend approximately 200 words. The ability to point to named body points, discuss past events, and point to pictures in a book when asked are communication skills associated with an older child.

When teaching an infant's mother about bathing her, it would be important to instruct her that

bath time provides an opportunity for play. Explanation: Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.

When teaching an infant's mother about bathing her, it would be important to instruct her that:

bath time provides an opportunity for play. Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?

be able to turn over onto the back Explanation: At four months of age, the infant is able to lift the head and look around. The infant can roll from prone to supine. When being pulled up, the head leads. The 4-month-old infant can make simple vowel sounds, laugh aloud, and vocalize in response to voices. A fear of strangers does not occur until the child is older and a 4-month-old infant has not developed emotionally to have "moody" periods and is dependent on parental care.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:

be able to turn over onto the back. Infants typically turn over front to back at 4 months, enlarging the area of the house that needs to be childproofed.

Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age, how many additional words do most children use? a) 3,000 words b) 1,000 words c) 2,000 words d) 1,500 words

c) 2,000 words Explanation: By the end of the fifth year, preschoolers use sentences that are adult-like in structure and know about 2,000 words.

A mother is concerned because her 2-year-old daughter is not speaking much. What should the nurse suggest to the mother? Select all that apply. a) Use pronouns when speaking to her. b) Use baby talk when speaking to her. c) Always answer her questions. d) Name aloud the objects that she is playing with. e) Read books aloud to her. f) Have her watch educational television.

c) Always answer her questions. d) Name aloud the objects that she is playing with. e) Read books aloud to her. Explanation: Reading aloud is an effective way to strengthen vocabulary. Also, urge parents to encourage language development by naming objects as they play with their child or when they give their toddler something. This helps children grasp the fact words are not meaningless sounds; they apply to people and objects and have uses. Always answering a child's questions is another good way to do this. Watching television promotes little learning as the activity is passive and it is difficult to discern how language caused the action. The American Academy of Pediatrics recommends television viewing should be severely limited until at least 2 years of age. Because children learn language from imitating what they hear, if they are spoken to in baby talk, their enunciation of words can be poor; if they hear examples of bad grammar, they will not use good grammar. Remind parents pronouns are difficult for children to use correctly; many children are 3½ or 4 years of age before they can separate the different uses of "I," "me," "him," and "her."

Which suggestion by the nurse meant to promote good dental health in the 15-month-old is inappropriate? a) Avoid grazing (continual snacking) throughout the day. b) Wean the child from the bottle. c) Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste. d) Arrange for your child's first dental visit as soon as possible.

c) Brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste. Explanation: Using fluoride toothpaste prior to age 2 years promotes development of fluorosis. The first dental visit should be made at 1 year. This check-up is overdue. Continual snacking and bottle drinking keep the teeth in contact with cariogenic substances for extended periods.

Which gross motor developmental milestone is least likely for a 2 year old? a) Jumps in place b) Climbs c) Rides a tricycle d) Stands on one foot with help

c) Rides a tricycle Explanation: A gross motor developmental milestone for a 2- to 3-year-old includes jumping in place. Riding a tricycle occurs at 3 to 4 years of age. Climbing occurs at occurs at 18 months to 2 years. At 12 to 18 months, the child can stand on one foot with help.

The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem? a) The child never squeals or yells. b) The child does not babble. c) The child does not vocally respond to voices. d) The child does not say dada or mama.

c) The child does not vocally respond to voices. Explanation: The fact that the child does not vocally respond to voices might suggest a developmental problem. At 4 to 5 months of age most children are making simple vowel sounds, laughing aloud, doing raspberries, and vocalizing in response to voices. The child is too young to babble, squeal, yell, or say dada or mama.

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child? a)"My 4-year-old eats as much as my adolescent does every day." b)"My husband is insistent that our 5-year-old not eat any snacks so he will eat he all of his meals at mealtime." c)"Our child gets into food jags where she will only eat one food all day long." d)"My child is so picky and eats the same thing every day for days on end!"

d) "My child is so picky and eats the same thing every day for days on end!" Explanation: The preschooler's appetite is erratic; at one sitting the preschooler may devour everything on the plate, and at the next meal he or she may be satisfied with just a few bites. Portions are smaller than adult-sized portions, so the child may need to have meals supplemented with nutritious snacks.

The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is most appropriate for this child? a) Explaining how to prepare table meats b) Advising about increased caloric needs c) Describing the tongue extrusion reflex d) Discussing the type of sippy cup to use

d) Discussing the type of sippy cup to use Explanation: The cup may be introduced at 6 to 8 months of age. Old-fashioned sippy cups are preferred compared to the new style. The nurse would not advise about increased caloric needs as caloric needs drop at this age. Transition to table meat will not take place until age 10 to 12 months. Tongue extrusion reflex has disappeared at age 4 to 6 months

The nurse is working with the caregivers of an infant. The caregivers tell the nurse their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and help the child develop a sense of security when the child's primary caregiver is out of sight? a)Slowly increase the amount of time she is allowed to cry before being picked up. b)Pick the child up as soon as she begins to cry. c)Give her dolls and stuffed animals so she learns to distract herself. d)Play "peek-a-boo" with the child when she is happy.

d) Play "peek-a-boo" with the child when she is happy. Explanation: For the infant, self-assurance is necessary to confirm that objects and people do not cease to exist when out of sight. This is a learning experience on which the infant's entire attitude toward life depends. The ancient game of "peek-a-boo" is a universal example of this learning technique. It is also one of the joys of infancy as the child affirms the ability to control the disappearance and reappearance of self. In the same manner by which the infant affirms self-existence, she learns to confirm the existence of others, even when they are temporarily out of sight

A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing? a) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior. b) The thought of losing his father was scary, and the child is trying to show his father how much he loves him. c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents. d) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident.

d) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident. Explanation: Preschoolers have learned to think about something without actually seeing it: to visualize or imagine. This normal development, sometimes called magical thinking, makes it difficult for them to separate fantasy from reality. Preschoolers believe that words or thoughts can make things real, and this belief can have either positive or negative results. The child needs reassurance that this is not so.

The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which statement is most accurate regarding the fine motor skills of a 3-year-old? a) The child can use scissors. b) The child can print a few letters. c) The child can tie his shoelaces. d) The child can button his clothes.

d) The child can button his clothes. Explanation: The 3-year-old is able to button their clothes and use a pencil or crayon. By the age of 4 to 5, the child can use scissors, tie shoelaces, and print his first name.

The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? a) The mother is suffering from depression. b) The mother describes an inadequate diet. c) The child is unperturbed by a loud noise. d) The child is homeless and has no toys.

d) The child is homeless and has no toys. Explanation: Children develop through play, so a child without any toys may have trouble developing the motor skills appropriate to his age. Maternal depression is a risk factor for poor cognitive development. Inadequate diet will cause growth deficiencies. A child who does not respond to a loud noise probably has hearing loss, which will lead to a language deficit.

The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to: a) teach her street-crossing safety. b) help her learn how to follow rules. c) provide her with clothes that snap rather than button. d) allow her to experiment with Play-Doh.

d) allow her to experiment with Play-Doh. Explanation: Preschoolers enjoy toys or material that they can manipulate (free-form play) because this helps them learn how things work.

A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to:

give him secondary, not primary, choices.

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:

increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive. Advances in health care have led to more children living with chronic illness or disability. The statements about genetic disease and older women may contain some truth but have only added a few people to the chronic illness total. Acute care pediatric nursing positions are decreasing in community hospitals but are more available in medical centers. Uninsured families may or may not be able to access nonhospital care. pg 6

looking for a toy in her crib at the last place she saw it.

looking for a toy in her crib at the last place she saw it. Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant's behaviors show use of her senses and motor activity but do not illustrate object permanence.

A nurse is considering employment in a practice that promotes family-centered care. When considering this position, the nurse recognizes that this philosophy will:

promote the involvement of the child and parents as members of the health care team. Family-centered care involves a mutually beneficial partnership between the child, the family, and health care professionals. It applies to the planning, delivery, and evaluation of health care for children of all ages in any setting.

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:

refer the infant for developmental and/or neurologic evaluation. There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem. Page 72

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:

refer the infant for developmental and/or neurologic evaluation. Explanation: There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.

The best way for an infant's father to help his child complete the developmental task of the first year is to:

respond to her consistently.

stranger anxiety. Explanation: Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:

the newborn's stomach can hold between one-half and 1 ounce.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:

the newborn's stomach can hold between one-half and 1 ounce. The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1.5 to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:

turn over onto back: Infants typically turn over front to back at 4 months, enlarging the area of the house that needs to be childproofed. Pg 72

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents?

• "Food is so expensive. I can't afford for my child to leave any food on the plate." • "I have tried at least 10 times with every green vegetable and I can't get my son to like them." • "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." -Encouraging children to eat everything on their plate can lead to overeating and obesity. Children may need to be exposed to new food at least 20 times before determining if they like it or not. Letting a child eat whatever he wants does not lead to good choices as the child matures

The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. Which of the following should be included in the teaching plan? Select all that apply.

• Advising the mother this behavior is a form of self-comfort • Assuring the mother this behavior won't cause malocclusion • Informing the mother that thumb sucking occurs more often during periods of stress • Telling the mother this behavior usually decreases by 6 to 9 months of age

The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething? Select all that apply.

• Drooling and biting • Increased sucking on hands • Irritability and awakening from sleep • Refusing to eat

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up?

• The infant has frequent episodes of crossed eyes. • The infant does not pay attention to noises behind him. • The infant seems disinterested in the surrounding environment.

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